Transcatheter Arterial Chemoembolization for Hepatic Carcinoma with Blood Supply from the Intercostal Arteries / 中国微创外科杂志

ABSTRACT

Objective To study the safety of transcatheter arterial chemoembolization(TACE)via the intercostal artery(ICA)for hepatic carcinoma.Methods A total of 24 patients with hepatic carcinoma(HCC)fed by the ICA underwent TACE via the artery in our hospital.Among the cases,15 were mass type and 9 were nodular type.Plain and enhanced CT or MRI scan were performed before the operation.During the procedure,we carried out intercostal arteriography.Selected catheterization of the feeding branch and then TACE were done.The ICA angiographic features,tumor location,clinical observation,laboratory tests,and imageology were evaluated after the surgery.Results In our cases,the HCCs supplied by the ICA collaterals were located at segments six and/or seven.Angiography showed that all the ICA collaterals originated from the right side at the levels of T8(7.5%,3/40),T9(15.0%,6/40),T10(47.5%,19/40),or T11(30.0%,12/40).The procedure was completed in 22 of the patients.CT scan performed after the procedure showed that the tumor was completely filled with lipiodol in 87.5%(21/24)of the cases.The serum level of AFP decreased significantly in 82.6%(19/23)of the patients.Three patients complained of severe pain at the shoulder after the operation,1 patient had skin itching during TACE,and 5 developed skin erythema after the procedure.Conclusions HCC supplied with ICA collaterals are often detected in the patients who have the tumor at the right posterior segment(S6 and S7)and had received TACE for several times.TACE via the ICA is safe but may leads to skin injuries.