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Original ArticleOpen Access
Transcatheter Oily Chemoembolization of the Extrahepatic Collaterals in Hepatocellular Carcinoma
Eurvilaichit C 
Twenty patients with hepatocellular carcinoma who had hepatic artery occlusion from
repeated transcatheter oily chemoembolization (TOCE), were treated with additional TOCE through
extrahepatic collaterals.
Repeated TOCE were performed through the inferior phrenic artery (10 patients), branches
of the gastroduodenal artery (6 patients), the internal mammary artery (2 patients), the pancreatico-
duodenal arcade (I patient), the accessory hepatic artery (I patient), the capsular branch of the
right renal artery (I patient) and the I2'h intercostal artery (I patient). The TOCE was unsuccessful
in 4 patients with accessory hepatic artery, one patient with cystic artery arising from superior
mesenteric artery, one patient with omentoepiploic artery and one patient with left gastric
anastomose with right gastric artery. The success rate of TOCE in the extrahepatic arteries was
76.67 per cent while there was a 23.33 per cent failure rate. The overall cumulative survival rates
were 80 per cent (6 months), 50 per cent (12 months) and I8.8 per cent (18 months).
One patient developed skin necrosis at the right chest wall following TOCE of the right
internal mammary artery for HCC. One patient developed hemiplegia following TOCE of the right
I2'h intercostal artery. The extrahepatic collaterals are important alternative routes for continuous
transcatheter management of hepatocellular carcinoma following hepatic artery occlusion.
Key word : Extrahepatic Collaterals, Hepatocellular Carcinoma, Transcatheter Oily Chemoemboli-
zation
repeated transcatheter oily chemoembolization (TOCE), were treated with additional TOCE through
extrahepatic collaterals.
Repeated TOCE were performed through the inferior phrenic artery (10 patients), branches
of the gastroduodenal artery (6 patients), the internal mammary artery (2 patients), the pancreatico-
duodenal arcade (I patient), the accessory hepatic artery (I patient), the capsular branch of the
right renal artery (I patient) and the I2'h intercostal artery (I patient). The TOCE was unsuccessful
in 4 patients with accessory hepatic artery, one patient with cystic artery arising from superior
mesenteric artery, one patient with omentoepiploic artery and one patient with left gastric
anastomose with right gastric artery. The success rate of TOCE in the extrahepatic arteries was
76.67 per cent while there was a 23.33 per cent failure rate. The overall cumulative survival rates
were 80 per cent (6 months), 50 per cent (12 months) and I8.8 per cent (18 months).
One patient developed skin necrosis at the right chest wall following TOCE of the right
internal mammary artery for HCC. One patient developed hemiplegia following TOCE of the right
I2'h intercostal artery. The extrahepatic collaterals are important alternative routes for continuous
transcatheter management of hepatocellular carcinoma following hepatic artery occlusion.
Key word : Extrahepatic Collaterals, Hepatocellular Carcinoma, Transcatheter Oily Chemoemboli-
zation
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