Redistribution of multiple hepatic arteries into a single hepatic artery to perform repeated hepatic arterial infusion chemotherapy.
BACKGROUND
In patients with two or more intrahepatic arteries, multiple intrahepatic arteries should be converted into a single intrahepatic artery before repeated hepatic arterial infusion chemotherapy. However, the number of reports investigating this has been scanty.


OBJECTIVE
To evaluate the usefulness of the redistribution of multiple hepatic arteries into a single hepatic artery for repeated hepatic arterial infusion chemotherapy (HAIC) through an indwelling port-catheter system for unresectable liver malignancies.


METHODS
In 76 patients with unresectable advanced liver cancer, redistribution of multiple hepatic arteries into one hepatic artery was performed prior to port-catheter system implantation. Investigated were distribution in the liver, as evaluated with computed tomography (CT) during arteriography via the port after implantation, and management of cases in which distribution in the entire liver was not achieved.


RESULTS
In 64 patients, good distribution in the entire liver was confirmed on CT arteriography via the port. In the remaining 12 patients, contrast material was heterogeneously distributed. The segments with poor distribution were segments VI, VII, VIII, and I. In the five patients with tumors in segments having poor distribution, the right inferior phrenic artery was successfully embolized and good distribution throughout the entire liver was thereafter achieved in all five.


CONCLUSIONS
In cases with multiple hepatic arteries, redistribution procedures allow application of repeated HAIC through a single indwelling catheter while maintaining distribution over the entire liver. However, care regarding hepatopetal flow of the right inferior phrenic artery is necessary.
Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan. yamagami@koto.kpu-m.ac.jp
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Yamagami
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Yoshimatsu
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Matsumoto
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Nishimura
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction; D001943:Breast Neoplasms / Q000473:pathology*; D002408:Catheters, Indwelling; D003287:Contrast Media / Q000008:administration & dosage; D004067:Digestive System Neoplasms / Q000473:pathology*; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006499:Hepatic Artery / Q000002:abnormalities* / Q000000981:diagnostic imaging; D006801:Humans; D008099:Liver / Q000098:blood supply*; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000556:secondary; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011856:Radiographic Image Enhancement / Q000379:methods; D036542:Tomography, Spiral Computed / Q000379:methods
D003287:Contrast Media