Arterial blood supply to the caudate lobe of the liver from the proximal branches of the right inferior phrenic artery in patients with recurrent hepatocellular carcinoma after chemoembolization

Abstract

To evaluate the arterial blood supply to the caudate lobe of the liver from the proximal branches of the right inferior phrenic artery (RIPA) in patients with recurrent hepatocellular carcinoma after transcatheter arterial chemoembolization (TACE). Thirteen patients, including 10 who had a history of TACE of the caudate artery (A1), underwent TACE of the proximal RIPA branches. Iodized oil distribution was evaluated by computed tomography (CT) 1-week after TACE. Angiographic findings were also evaluated. Previously embolized A1 was occluded (n = 15) or attenuated (n = 2). In one of three patients without A1 TACE, A1 was also attenuated. TACE was performed at the first branch of the proximal RIPA (n = 8), the first branch of the anterior branch (n = 6), and the first branch of the posterior branch (n = 1), respectively. Iodized oil was mainly distributed into the dorsal part of the Siegel lobe (SP) (n = 10), the caudate process (n = 1), and both (n = 2). In three of seven patients who had undergone serial RIPA angiography, RIPA parasitization to SP was suspected before A1 TACE. The proximal RIPA branches mainly supply the SP when A1 is attenuated.