Development of extrahepatic arterial blood supply to the liver during hepatic arterial infusion chemotherapy

Eur Radiol. 1998;8(9):1613-8. doi: 10.1007/s003300050597.

Abstract

The aim of this study was to evaluate the correlation of development of the collateral circulation to the liver during hepatic arterial infusion chemotherapy (HAIC) with the presence of hepatic tumours adjacent to the hepatic surface, and with pretreatment occlusion of aberrant hepatic arteries. In 102 patients with unresectable malignant hepatic tumours treated with HAIC using an implantable port system, development of collaterals to the liver was assessed with CT arteriography using the implantable port and pre- and postoperative angiography. Aberrant hepatic arteries, if present, were occluded prior to treatment for hepatic arterial redistribution. Collaterals to the liver were seen in 29 patients, who had 35 areas with collateral perfusion: 22 areas were in the right posterosuperior area, 6 in the left peripheral area and 7 in the right or left lobar area. Collaterals were revealed more frequently in patients with hepatic tumours adjacent to the hepatic surface than in those without hepatic tumours in peripheral areas in the liver (p < 0.0001). In addition, collaterals developed more frequently in patients with an aberrant hepatic arterial anatomy compared with those with conventional anatomy (p = 0.0007). Our results indicated that patients with hepatic tumours adjacent to the hepatic surface and with pretreatment occlusion of aberrant hepatic arteries had the potential to develop collaterals to the liver during HAIC.

MeSH terms

  • Adult
  • Aged
  • Angiography
  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents / therapeutic use*
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Carcinoma, Hepatocellular / blood supply
  • Carcinoma, Hepatocellular / diagnostic imaging
  • Carcinoma, Hepatocellular / drug therapy
  • Catheters, Indwelling
  • Cholangiocarcinoma / blood supply
  • Cholangiocarcinoma / diagnostic imaging
  • Cholangiocarcinoma / drug therapy
  • Collateral Circulation / physiology*
  • Embolization, Therapeutic
  • Female
  • Hepatic Artery
  • Humans
  • Injections, Intra-Arterial
  • Liver / blood supply*
  • Liver / diagnostic imaging
  • Liver Circulation / physiology
  • Liver Neoplasms / blood supply
  • Liver Neoplasms / diagnostic imaging
  • Liver Neoplasms / drug therapy*
  • Liver Neoplasms / secondary
  • Male
  • Middle Aged
  • Neovascularization, Pathologic / diagnostic imaging
  • Neovascularization, Pathologic / pathology
  • Retrospective Studies
  • Tomography, X-Ray Computed

Substances

  • Antineoplastic Agents