Chemoembolization through Intercostal Arteries in Hepatocellular Carcinoma' Report of A Case of Transient Spinal Cord Injury

ABSTRACT

Liver has a dual blood supply from portal vein and hepatic artery. Hepatocellular carcinoma receive their blood supply almost exclusively from hepatic artery. Thus, the concept of treating hepatocellular carcinoma by chemoembolization through these arteries is very effective. However, there may be several collateral or parasitic vessels feeding them in case of huge tumor or previous chemoembolization. We experierced a case of huge tumor involving right upper posterior portion of liver fed by 9th, 10th, 11th right posterior intercostal arteries and an anomalous hepatic artery. We tried chemoembolization with Adriamycin-Lipiodol suspension and Gelfoam material through the right posterior intercostal arteries to treat the lesion. After the procedure, the patient(55 years old female) became paraplegic with voiding and defecation difficulty which could be due to spinal cord infarction .by anterior spinal arteri. al occlusion caused by embolic material through the artery of Adamkiewicz from a posterior intercostal artery. She recovered completely after 20 days of treatment.