title: Transarterial chemoembolization of a colic branch of the superior mesenteric artery in patients with unresectable hepatocellular carcinoma.
abstract: OBJECTIVE
  To evaluate the technical feasibility, safety, and imaging response of transarterial chemoembolization performed through a colic branch of the superior mesenteric artery (SMA) in patients with hepatocellular carcinoma (HCC).
  
  
  METHODS
  Between July 2000 and June 2009, we observed tumor staining supplied by a colic branch of the SMA in 61 of 5,095 patients (1.2%) with HCC. Computed tomography (CT) scans and digital subtraction angiograms of these patients were retrospectively reviewed by two investigators in consensus to evaluate the tumor location, the technical success of chemoembolization, complications, and imaging response on a follow-up CT scan according to European Association for the Study of the Liver criteria.
  
  
  RESULTS
  Tumors supplied by a colic branch of the SMA were located in segment VI (n = 58) or were extrahepatic metastases caused by peritoneal seeding (n = 3). Vessels supplying the tumor arose from the right colic artery (n = 23), middle colic artery (n = 22), or ileocolic artery (n = 26). Selective chemoembolization via a colic branch of the SMA was performed in 24 patients (39%). No patient developed symptoms related to colon ischemia. Complete response or partial response of the tumor fed by a colic branch of the SMA as depicted on follow-up CT was achieved in eight patients (33%).
  
  
  CONCLUSIONS
  Chemoembolization via a colic branch of the SMA can be safely performed if the microcatheter can be advanced beyond the antimesenteric border of the colon.
authors.affiliation: Department of Radiology, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Hyo-Cheol
authors.initials: HC
authors.lastname: Kim
authors.forename: Jin Wook
authors.initials: JW
authors.lastname: Chung
authors.forename: Sangbu
authors.initials: S
authors.lastname: An
authors.forename: Nak Jong
authors.initials: NJ
authors.lastname: Seong
authors.forename: Kyu Ri
authors.initials: KR
authors.lastname: Son
authors.forename: Hwan Jun
authors.initials: HJ
authors.lastname: Jae
authors.forename: Jae Hyung
authors.initials: JH
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D015901:Angiography, Digital Subtraction; D006528:Carcinoma, Hepatocellular / Q000098:blood supply / Q000000981:diagnostic imaging / Q000628:therapy*; D057785:Catheters; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D017538:Mesenteric Artery, Superior / Q000000981:diagnostic imaging; D008875:Middle Aged; D008904:Miniaturization; D056910:Republic of Korea; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult