title: Repeated intra-arterial therapy via the cystic artery for hepatocellular carcinoma.
abstract: OBJECTIVE
  To evaluate the postprocedural imaging findings and safety of repeated intra-arterial therapy via the cystic artery in patients with hepatocellular carcinoma (HCC).
  
  
  METHODS
  This retrospective study was approved by our institutional review board. From February 2002 to January 2012, we performed repeated (two or more) chemotherapeutic infusion or chemoembolization via the cystic artery using iodized oil in 132 patients with HCCs. Computed tomographic (CT) scans, digital subtraction angiograms, and medical records were retrospectively reviewed by consensus.
  
  
  RESULTS
  A total of 340 sessions of intra-arterial therapy (160 sessions of chemotherapeutic infusion and 180 sessions of chemoembolization) via the cystic artery were undertaken in 132 patients. Fifty-five of 132 patients received both chemotherapeutic infusion and chemoembolization. The incidence of gallbladder wall thickening on follow-up contrast-enhanced CT was significantly higher in chemoembolization (48 of 180, 26.7 %) than in chemotherapeutic infusion (27 of 160, 16.9 %) (P = 0.035). Persistent gallbladder wall thickening was more frequently observed in chemoembolization (48 of 107, 44.9 %) than in chemotherapeutic infusion (27 of 90, 30 %) (P = 0.039). The major complication rate was 15 of 340 sessions (4.4 %) with 11 of 132 patients (8.3 %). Acute cholecystitis, which was related to intra-arterial therapy via the cystic artery, developed in two patients and was managed by conservative treatment.
  
  
  CONCLUSIONS
  HCC supplied by the cystic artery can be safely treated by repeated intra-arterial chemotherapeutic infusion or chemoembolization using iodized oil through the cystic artery.
authors.affiliation: Department of Radiology, Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center, and Clinical Research Institute, Seoul National University Hospital, #28 Yongon-dong, Chongno-gu, Seoul, 110744, Korea.
authors.forename: Hee Ho
authors.initials: HH
authors.lastname: Chu
authors.forename: Hyo-Cheol
authors.initials: HC
authors.lastname: Kim
authors.forename: Jin Wook
authors.initials: JW
authors.lastname: Chung
authors.forename: Jeong-Hoon
authors.initials: JH
authors.lastname: Lee
authors.forename: Su Jong
authors.initials: SJ
authors.lastname: Yu
authors.forename: Saebeom
authors.initials: S
authors.lastname: Hur
authors.forename: Hwan Jun
authors.initials: HJ
authors.lastname: Jae
authors.forename: Jae Hyung
authors.initials: JH
authors.lastname: Park
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction / Q000379:methods; D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D004317:Doxorubicin / Q000627:therapeutic use; D005260:Female; D006499:Hepatic Artery / Q000000981:diagnostic imaging; D006801:Humans; D007459:Iodized Oil / Q000627:therapeutic use; D008113:Liver Neoplasms / Q000188:drug therapy / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D019233:Retreatment; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000903:Antibiotics, Antineoplastic; D007459:Iodized Oil; D004317:Doxorubicin