title: Hepatic falciform artery: is prophylactic embolization needed before short-term hepatic arterial chemoinfusion?
abstract: OBJECTIVE
  The purpose of this study was to assess the need for prophylactic embolization of the hepatic falciform artery (HFA) to prevent supraumbilical skin rash before short-term hepatic arterial chemoinfusion with or without subsequent embolization.
  
  
  METHODS
  Transcatheter arterial chemoinfusions or chemoembolizations were performed on 127 consecutive patients with hepatocellular carcinoma between August 1997 and September 1997. Hepatic angiography findings regarding the anatomic variations of the hepatic artery and the presence and origin of the HFA were analyzed. The patients were followed up for 35-143 days (mean, 78 days). The incidence of supraumbilical skin rash was assessed for two groups of patients, those with an HFA and those without. We also evaluated other factors that seemed closely related to the presence of an HFA.
  
  
  RESULTS
  An HFA was identified in 16 (13%) of 127 patients. Each HFA originated either in the left hepatic artery (n = 14) or the middle hepatic artery (n = 2). In the 16 patients with an HFA, serum bilirubin levels were significantly higher than in patients without one (p < .05), whereas serum albumin levels and prothrombin times were significantly lower (p < .05) and more prolonged (p = .02) than in patients without one. Portal venous collateral vessels were more frequently seen in patients with an HFA (50%) than in those without one (31%), but the frequency was not significant (p = .157). However, supraumbilical skin rash was not seen in any patient.
  
  
  CONCLUSIONS
  We found no need for prophylactic embolization of the HFA to prevent supraumbilical skin rash before short-term hepatic arterial chemoinfusion with or without subsequent embolization.
authors.affiliation: Department of Diagnostic Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: D E
authors.initials: DE
authors.lastname: Kim
authors.forename: H K
authors.initials: HK
authors.lastname: Yoon
authors.forename: G Y
authors.initials: GY
authors.lastname: Ko
authors.forename: J S
authors.initials: JS
authors.lastname: Kwon
authors.forename: H Y
authors.initials: HY
authors.lastname: Song
authors.forename: K B
authors.initials: KB
authors.lastname: Sung
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000188:drug therapy; D002406:Catheterization, Peripheral / Q000295:instrumentation / Q000379:methods; D016461:Chemoembolization, Therapeutic / Q000295:instrumentation / Q000379:methods*; D005076:Exanthema / Q000139:chemically induced / Q000517:prevention & control; D005260:Female; D006499:Hepatic Artery / Q000000981:diagnostic imaging; D006801:Humans; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D011859:Radiography; D013997:Time Factors; D014472:Umbilicus