title: Cutaneous complications after transcatheter arterial treatment for hepatocellular carcinoma via the internal mammary artery: how to avoid this complication.
abstract: OBJECTIVE
  To lower the rate of cutaneous complications after transcatheter arterial treatment for hepatocellular carcinoma (HCC) via the internal mammary artery (IMA) we retrospectively assessed the complications.
  
  
  METHODS
  We reviewed cutaneous complications in 14 patients with 18 HCCs who had undergone 17 treatment procedures via the IMA, including selective transcatheter arterial infusion chemotherapy with Lipiodol (Lip-TAI) (n = 3), selective Lip-TAI + transcatheter arterial embolization (TAE) (n = 3), nonselective Lip-TAI (n = 1), nonselective Lip-TAI + TAE (n = 5), and nonselective TAE (n = 5). The filling and nonfilling of subcutaneous vessels with Lipiodol was examined on postoperative computed tomography (CT) scans.
  
  
  RESULTS
  Skin rash (n = 3) and ulceration (n = 1) occurred after 4 of 17 (24%) procedures: two of three selective Lip-TAI procedures and two of five nonselective Lip-TAI + TAE procedures. The doses of chemotherapeutic agents for tumor sizes in selective Lip-TAI procedures were higher than those in selective Lip-TAI + TAE procedures. Cutaneous complications were encountered after two of three procedures with filling but not after any of eight procedures without filling.
  
  
  CONCLUSIONS
  A lower dose of chemotherapeutic agents may be less risky when undertaking a selective procedure via the IMA for HCC. If nonselective, TAE alone may be less risky. Postoperative CT may be helpful for predicting cutaneous complications.
authors: Department of Radiology, Hiroshima City Hospital, Hiroshima, Japan.
authors: Kenji
authors: K
authors: Kajiwara
authors: Hideaki
authors: H
authors: Kakizawa
authors: Naoko
authors: N
authors: Takeuchi
authors: Naoyuki
authors: N
authors: Toyota
authors: Masashi
authors: M
authors: Hieda
authors: Masaki
authors: M
authors: Ishikawa
authors: Keizo
authors: K
authors: Tanitame
authors: Chihiro
authors: C
authors: Tani
authors: Takayuki
authors: T
authors: Suzuki
authors: Koichi
authors: K
authors: Fujikawa
authors: Hiroshi
authors: H
authors: Aikata
authors: Kazuaki
authors: K
authors: Chayama
authors: Kazuo
authors: K
authors: Awai
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D006528:Carcinoma, Hepatocellular / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D054796:Drug Dosage Calculations; D004998:Ethiodized Oil / Q000008:administration & dosage / Q000009:adverse effects*; D005076:Exanthema / Q000139:chemically induced / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000628:therapy*; D008297:Male; D008323:Mammary Arteries; D008875:Middle Aged; D011183:Postoperative Complications / Q000139:chemically induced / Q000000981:diagnostic imaging; D012189:Retrospective Studies; D012871:Skin Diseases / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000517:prevention & control*; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D004998:Ethiodized Oil