Analysis of Extrahepatic Collateral Arteries in Transcatheter Arterial Chemoembolization of Hepatocellular Carcinoma

Objective: Development of extrahepatic collateral arteries (ECAs) supply to hepatocellular carcinoma (HCC) can interfere effective control of tumor by transcatheter arterial chemoembolization (TACE) treatment. The aim of this study is to analyze the prevalence and causative factors of ECAs to HCC and complications of TACE through each ECAs. Methods: We performed a retrospective review of total 1,374 procedures from 639 patients with a diagnosis of HCC who were sent for TACE (range from 1 - 16 sessions, mean = 2.87 sessions) from January 2008 - May 2010. Prevalence, causative factors such as size and location of the tumor and previous treatment were analyzed. Results: There are 122 (19.09%) from 639 patients that showed ECAs supplying the tumors. The prevalence of ECAs to HCC was 34.39% from right inferior phrenic artery, 30.68% from omental artery, 9.52% from left gastric artery, 5.82% from left inferior phrenic artery, 5.29% from colic branch of superior mesenteric artery (SMA) and 4.23% from intercostal artery. Statistical analysis showed that tumor size of more than 8-10 cm and location at hepatic surface, especially liver bare area were significantly associated with the presence of ECAs (p