title: Chemoembolization for hepatocellular carcinoma supplied exclusively by the hepatic falciform artery.
abstract: OBJECTIVE
  The purpose of this study was to describe imaging appearances of hepatocellular carcinoma (HCC) supplied exclusively by the hepatic falciform artery (HFA) and safety of chemoembolization via the HFA.
  
  
  METHODS
  During the past 6 years, we have performed chemoembolization for the treatment of 12 patients with HCCs supplied exclusively by the HFA. Computed tomography (CT) scans, digital subtraction angiograms, and medical records were retrospectively reviewed by consensus.
  
  
  RESULTS
  Tumors were located in Couinaud segments IV (n = 7) and III (n = 5) and in subcapsular areas around the falciform ligaments. Tumor size ranged from 1.0 to 1.8 cm (mean, 1.3 cm; median, 1.3 cm). HFAs originated from A4 (n = 7), A3 (n = 4), and the left hepatic artery near the umbilical point (n = 1). All tumors were supplied exclusively by the HFA. Prophylactic embolization of the distal HFA before chemoembolization was performed using gelatin sponge particles in only one patient, and selective chemoembolization via the HFA was achieved in all patients. One patient suffered from a skin rash after chemoembolization and recovered after conservative management. Individual responses of tumors supplied exclusively by the HFA were complete response (n = 8), partial response (n = 1), and stable disease (n = 2) at the first follow-up enhanced CT scan.
  
  
  CONCLUSIONS
  The HFA can supply HCC located in subcapsular areas around the falciform ligament, and the tumors can be safely chemoembolized without significant complications.
authors.affiliation: Department of Radiology, Seoul National University College of Medicine, Korea.
authors.forename: Gyoung Min
authors.initials: GM
authors.lastname: Kim
authors.forename: Hyo-Cheol
authors.initials: HC
authors.lastname: Kim
authors.forename: Jin Wook
authors.initials: JW
authors.lastname: Chung
authors.forename: In Joon
authors.initials: IJ
authors.lastname: Lee
authors.forename: Han Myun
authors.initials: HM
authors.lastname: Kim
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 / Q000000981:diagnostic imaging / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D003287:Contrast Media; D005260:Female; D006801:Humans; D008099:Liver / Q000098:blood supply*; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media