Hepatic arterial flow distribution with hepatic neoplasms: significance in infusion chemotherapy

Hepatic artery radionuclide flow studies and hepatic angiography in eight patients with various hepatic neoplasms were evaluated to determine the patterns of arterial flow distribution in the presence of portal vein occlusion. Increased hepatic arterial blood flow to the lobe or segment supplied by the occluded portal vein was observed in all patients. This phenomenon must be taken into account when positioning catheters for hepatic artery infusion chemotherapy; while it may improve the flow of chemotherapeutic agents to tumors located in the area of an occluded portal vein branch, it may also result in diversion of flow to the normal hepatic parenchyma away from tumors occupying the hepatic segments with patent portal venous flow. Hepatic angiography and radionuclide flow studies provide the necessary information for correct positioning of hepatic artery infusion catheters.