Brief Reports
Copyright ©2005 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. May 7, 2005; 11(17): 2637-2642
Published online May 7, 2005. doi: 10.3748/wjg.v11.i17.2637
Influential factors and formation of extrahepatic collateral artery in unresectable hepatocellular carcinoma
Yong-Li Wang, Ming-Hua Li, Ying-Sheng Cheng, Hai-Bing Shi, Hai-Lun Fan
Yong-Li Wang, Ming-Hua Li, Ying-Sheng Cheng, Department of Diagnostic and Interventional Radiology, The Affiliated Sixth People’s Hospital of Shanghai Jiaotong University, Shanghai 200233, China
Hai-Bing Shi, Department of Radiology, The First Affiliated People’s Hospital of Nanjing Medical University, Nanjing 210002, Jiangsu Province, China
Hai-Lun Fan, Department of Interventional Radiology, The Affiliated General Hospital of Tianjin Medical University, Tianjin 300052, China
Author contributions: All authors contributed equally to the work.
Correspondence to: Yong-Li Wang, MD, Department of Diagnostic and Interventional Radiology, The Affiliated Sixth People’s Hospital of Shanghai Jiaotong University , 600 Yi Shan Rd, Shanghai 200233, China. wylzxy@tom.com
Telephone: +86-21-64844183 Fax: +86-21-64844183
Received: May 31, 2004
Revised: June 1, 2004
Accepted: June 28, 2004
Published online: May 7, 2005
Abstract

AIM: To analyze the influence factors and formation of extrahepatic collateral arteries (ECAs) in unresectable hepatocellular carcinoma (HCC) with or without chemoe-mbolization.

METHODS: Detailed histories of 35 patients with 39 ECAs of HCC and images including computerized tomography scan, digital subtraction angiography were reviewed carefully to identify ECAs of HCC, ECAs arising from, and anatomic location of tumors in liver. Tumor sizes were measured, and relations of ECAs with times of chemoemb-olization, tumor size, and the anatomic tumor location were analyzed. Complications were observed after chemoemb-olization through ECAs of HCC with different techniques.

RESULTS: Influence factors of formation of ECAs of HCC included the times of repeated chemoembolization, the location of tumors in liver, the tumor size and the types of chemoembolization. ECAs in HCC appeared after 3-4 times of chemoembolization (17.9%), but a higher frequency of ECAs occurred after 5-6 times of chemoem-bolization (56.4%). ECAs presented easily in peripheral areas (71.8%) of liver abutting to the anterior, posterior abdominal walls, the top right of diaphragm and right kidney. ECAs also occurred easily after complete obstruction of the trunk arteries supplying HCCs or the branches of proper hepatic arteries. Extrahepatic collaterals of HCC originated from right internal thoracic (mammary) artery (RITA, 5.1%), right intercostal artery (RICA, 7.7%), left gastric artery (LGA, 12.8%), right inferior phrenic artery (RIPA, 38.5%), omental artery (OTA, 2.6%), superior mesenteric artery (SMA, 23.1%), and right adrenal and renal capsule artery (RARCA, 10.3%), respectively. The complications after chemoembolization attributed to no super selective cathet-erization.

CONCLUSION: The formation of ECAs in unresectable HCC is obviously correlated with multiple chemoembolization, tumor size, types of chemoembolization, anatomic location of tumors. Extrahepatic collaterals in HCC are corresponding to the tumor locations in liver.

Keywords: ECAs, HCC