Chemoembolization for hepatocellular carcinoma supplied by a lumbar artery
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Updated: Apr 29, 2026
Transradial Access Chemoembolization for Hepatocellular Carcinoma Patients
Published on: September 20, 2020
Han Myun Kim1, Hyo-Cheol Kim, Sungmin Woo
1Department of Radiology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea, seoul49@naver.com.
Insights
Lumbar artery supply to hepatocellular carcinoma (HCC) is rare, often occurring in the liver's bare area. While chemoembolization is feasible, it typically yields unfavorable tumor response.
Area of Science:
- Interventional Radiology
- Hepatobiliary Oncology
- Vascular Imaging
Background:
- Hepatocellular carcinoma (HCC) can rarely be supplied by aberrant lumbar arteries.
- Understanding these vascular variations is crucial for effective treatment planning.
Purpose of the Study:
- To detail the imaging findings of HCC supplied by lumbar arteries.
- To evaluate the treatment response to chemoembolization in these cases.
Main Methods:
- Retrospective review of 21 patients with HCC supplied by lumbar arteries (2004-2012).
- Analysis of computed tomography (CT) scans and digital subtraction angiography.
- Assessment of chemoembolization procedures and imaging-based tumor response.
Main Results:
- HCC was predominantly located in the liver's bare area (67%) or segment VI (33%).
- Selective chemoembolization was successful in most patients, with no major complications.
- Overall tumor response was frequently progressive disease (20/21 patients).
Conclusions:
- Lumbar arteries can supply HCC, particularly in the inferior liver segments.
- Selective chemoembolization is technically achievable but often results in poor treatment outcomes.
Purpose:
To describe the radiologic findings and imaging response of hepatocellular carcinoma (HCC) supplied by the lumbar artery.
Methods:
Between April 2004 and December 2012, we encountered HCC supplied by a lumbar artery in 21 patients. Two investigators retrospectively reviewed clinical and radiological findings of HCC supplied by the lumbar artery using computed tomography (CT) scans and digital subtraction angiograms.
Results:
Patients had received 1-27 sessions of previous chemoembolization procedures (mean 7.7 sessions, median 4 sessions). Mean tumor size was 5.3 cm. The locations of HCC supplied by lumbar artery were the bare area (n = 14, 67 %) and segment VI (n = 7, 33 %). Tumor-feeding arteries arose from the main lumbar artery (n = 7), proximal anterior division (n = 4), and distal anterior division (n = 14). In 20 patients, selective chemoembolization through the tumor-feeding arteries of the lumbar artery was achieved. In 1 patient, nonselective embolization at the main lumbar artery was performed. There was no complication such as skin necrosis or paralysis. On the first follow-up enhanced CT scan, target tumors fed by the lumbar artery showed complete response (n = 6), partial response (n = 4), stable disease (n = 3), and progressive disease (n = 8), but overall tumor response was partial response (n = 1) and progressive disease (n = 20).
Conclusion:
When HCC is located in the inferior tip or bare area of the liver, a lumbar artery may supply the tumor. Although selective chemoembolization via the tumor-feeding vessel of the lumbar artery can be achieved in most cases, overall tumor response is commonly unfavorable.
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