Preoperative microcoil embolization of the common hepatic artery for pancreatic body cancer

Figure 1 Schematic drawing of microcoil embolization under proximal balloon inflation (A) and distal balloon inflation (B) in the common hepatic artery. LGA: Left gastric artery; CHA: Common hepatic artery; SA: Splenic artery; SMA: Superior mesenteric artery.

Figure 2 Microcoil embolization under distal balloon inflation. A: Radiograph during catheterization shows microcatheter (arrow) insertion to the common hepatic artery (CHA) via the celiac artery under distal microballoon inflation in the CHA; B: Radiograph during microcoil embolization shows a tight widthwise frame; C: Superior mesenteric arteriography after microcoil embolization shows blood flow from the superior mesenteric artery to the proper hepatic artery via the pancreatico-duodenal arcades.

Figure 3 Distal migration of the microcoils and the successful withdraw. A: Following celiac arteriography; B: Microcoil embolization under proximal balloon inflation (arrow) was performed; C: Microcoil migration from the common hepatic artery (CHA) to the proper hepatic artery occurred after deflation of the proximal balloon catheter; D: Under fluoroscopic guidance using the tube angle that enabled the best visualization of the CHA and with the assistance of a microwire, a microballoon catheter was then inserted through the migrated coil and inflated; E: The migrated coils were withdrawn to their original position in the CHA by the inflated balloon catheter.