Comparison of long-term effects between intra-arterially delivered ethanol and Gelfoam for the treatment of severe arterioportal shunt in patients with hepatocellular carcinoma

Figure 1 Multiple HCC nodules in a 34-year-old patient. A: CT image obtained during the arterial phase showed the predominant enhancement of the medial segment of left lobe and the enhancement of left portal branches, which represent APS. B: Hepatic arteriogram demonstrated the arterioportal shunt. C: The microcatheter was inserted into the feeding artery of APS. DSA showed the strong or fast blood flow of APS. D-E: Hepatic arteriogram showed that the arterioportal shunt was no longer visible after embolization with a microcoil and ethanol. F: Follow-up CT scan showed lipiodol accumulation in multiple HCC nodules, and liver necrosis was not seen in the distribution of the hepatic artery which had been treated with ethanol.