This case series describes an approach for radiation segmentectomy-style treatment of hepatic tumors fed by arteries unsuitable for catheterization. The 15-patient cohort (17 cases from 2015 to 2018) included those diagnosed with liver tumors (14 hepatocellular carcinoma, 1 cholangiocarcinoma, 1 renal-cell carcinoma, and 1 metastatic colorectal carcinoma) and chosen for radioembolization via a multimodal approach. In each case, a balloon microcatheter was used to temporarily redistribute intrahepatic flow during infusion for enhanced radioembolic agent delivery to the tumor. A median of 199 Gy was delivered to a median of 3% of total liver volume. Based on modified Response Evaluation Criteria In Solid Tumors, 11 cases had complete responses and 6 had partial responses.
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