title: Solitary hepatocellular carcinoma fed by the cystic artery: limitation of transcatheter arterial embolization.
abstract: OBJECTIVE
  To clarify the limitations of transcatheter treatment for hepatocellular carcinoma (HCC) with parasitic feeders from the cystic artery.
  
  
  METHODS
  Three male patients had a solitary HCC (average diameter 3 cm) fed by the cystic artery among 221 patients with HCC from 1994 to 1997. One tumor was nourished entirely from the cystic artery arising from the medial branch of the left hepatic artery, and two tumors were fed partially by the cystic arteries arising from the anterior inferior branch of the right hepatic artery. We analyzed the indications for transcatheter treatment for these three patients.
  
  
  RESULTS
  We chose not to embolize the cystic artery for fear of necrosis of the gallbladder. Although embolization of the anterior branch of the right hepatic artery was performed in one patient with a tumor fed partially by the cystic artery, only half the tumor was embolized. Two patients underwent hepatic resection, and one received percutaneous ethanol injection therapy. At follow-up of 28-40 months (average 33 months) all patients are alive.
  
  
  CONCLUSIONS
  Feeding by the cystic artery represents a limitation of TAE for HCC.
authors.affiliation: Department of Radiology, Kobe University School of Medicine, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Hirota
authors.forename: S
authors.initials: S
authors.lastname: Matsumoto
authors.forename: T
authors.initials: T
authors.lastname: Fukuda
authors.forename: T
authors.initials: T
authors.lastname: Yoshikawa
authors.forename: T
authors.initials: T
authors.lastname: Motohara
authors.forename: S
authors.initials: S
authors.lastname: Ichikawa
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000098:blood supply / Q000000981:diagnostic imaging / Q000628:therapy*; D004621:Embolization, Therapeutic / Q000379:methods; D006801:Humans; D008113:Liver Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D011172:Portography; D014057:Tomography, X-Ray Computed