Supplemental transcatheter arterial chemoembolization for hepatocellular carcinoma fed by collateral omental artery

To evaluate the efficacy and safety of supplemental transcatheter arterial chemoembolization (TACE) through the extrahepatic collateral omental artery (OA) for hepatocellular carcinoma (HCC).

We retrospective evaluated extrahepatic collateral OA on 34 patients, among 1826 patients with HCC who had undergone TACE. TACE of the OA was performed, and the dosage of emulsion was judged by tumor size and achievement of stagnant arterial flow.

Blood supply from the OA was demonstrated at the initial TACE in 7 patients, and after several TACE (mean 2.8th) sessions in 27 patients. The technical success rate was 100%. Total occlusion of the OA collateral was achieved in 85.3%. On one month later, complete, more than 50% and less than 50% uptake of iodized oil in the tumor were in 12, 16, and 6 patients, respectively. Alpha-fetoprotein level 1 month later was significantly lower than pre-procedure (P<0.05). There was no serious complication that related to the omental embolization. The cumulative survival rates at 6, 12 months were 94.1%, 85.3%, respectively.

TACE of the OA is safe and reduce the incidence of post-TACE recurrence and/or residual of HCC, and could improve the therapeutic effect of TACE in the treatment of HCC.