Scholarlink

Background <p>Transcatheter arterial chemoembolization (TACE) is regarded as the first-line non-surgical management option for hepatocellular carcinoma (HCC). Subsequent development of extrahepatic collateral vessels markedly impairs the efficiency of TACE. Such collaterals may have various patterns as they easily change according to the tumor size and location. </p> Aim <p>To describe the pattern of extrahepatic collateral supply in patients with recurrent HCC who were previously treated with chemoembolization at our department.</p> Methods <p>A prospective interventional single-arm study that included 15 patients with recurrent HCC who underwent previous TACE sessions. Patients were retreated with TACE and the pattern of extrahepatic collateral supply noted was described.</p> Results <p>The recurrent HCC lesions had a mean diameter of 6.60 ± 1.72 cm. Most extrahepatic collaterals (93.3%) occurred in tumors with a diameter &gt; 5 cm. Collateral vasculature development was closely associated with the number of prior TACE interventions. The most common extrahepatic collaterals came from the inferior phrenic artery (60.0%), followed by the gastroduodenal artery (26.7%), internal mammary artery (6.7%) and suprarenal artery (6.7%). Based on the findings, we recommend that: (1) in tumor lesions located in liver segments 4a/8, 7 and 8 that are in close proximity to the right hemidiaphragm, right inferior phrenic artery selective angiography is considered obligatory, (2) for tumor lesions located in segments 4b, 5 and 6 in close contact with the duodenum, selective catheterization of the gastroduodenal artery should be considered, (3) right internal mammary artery selective angiography is recommended in patients with large tumor lesions adjacent to the ventral diaphragmatic aspect, and (4) tumor lesions located in the posteroinferior segment of the right hepatic lobe (e.g., segment 6) may receive collaterals from the right suprarenal arteries.</p> Conclusions <p>Our findings confirm previous reports that extrahepatic supply in HCC is associated with larger tumors, peripheral tumor location, and multiple TACE sessions, while also identifying four common EHCAs and their corresponding liver segments.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Pattern of extrahepatic collateral supply in recurrent hepatocellular carcinoma post-transcatheter arterial chemoembolization

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年5月1日

查看全文
  • Minatallah Elsadek,
  • Mohamed El-Gharieb,
  • Allam Elsayed

摘要

Background

Transcatheter arterial chemoembolization (TACE) is regarded as the first-line non-surgical management option for hepatocellular carcinoma (HCC). Subsequent development of extrahepatic collateral vessels markedly impairs the efficiency of TACE. Such collaterals may have various patterns as they easily change according to the tumor size and location.

Aim

To describe the pattern of extrahepatic collateral supply in patients with recurrent HCC who were previously treated with chemoembolization at our department.

Methods

A prospective interventional single-arm study that included 15 patients with recurrent HCC who underwent previous TACE sessions. Patients were retreated with TACE and the pattern of extrahepatic collateral supply noted was described.

Results

The recurrent HCC lesions had a mean diameter of 6.60 ± 1.72 cm. Most extrahepatic collaterals (93.3%) occurred in tumors with a diameter > 5 cm. Collateral vasculature development was closely associated with the number of prior TACE interventions. The most common extrahepatic collaterals came from the inferior phrenic artery (60.0%), followed by the gastroduodenal artery (26.7%), internal mammary artery (6.7%) and suprarenal artery (6.7%). Based on the findings, we recommend that: (1) in tumor lesions located in liver segments 4a/8, 7 and 8 that are in close proximity to the right hemidiaphragm, right inferior phrenic artery selective angiography is considered obligatory, (2) for tumor lesions located in segments 4b, 5 and 6 in close contact with the duodenum, selective catheterization of the gastroduodenal artery should be considered, (3) right internal mammary artery selective angiography is recommended in patients with large tumor lesions adjacent to the ventral diaphragmatic aspect, and (4) tumor lesions located in the posteroinferior segment of the right hepatic lobe (e.g., segment 6) may receive collaterals from the right suprarenal arteries.

Conclusions

Our findings confirm previous reports that extrahepatic supply in HCC is associated with larger tumors, peripheral tumor location, and multiple TACE sessions, while also identifying four common EHCAs and their corresponding liver segments.