Internal mammary artery embolization for hepatic tumors

Area of Science:

• Interventional Radiology
• Oncology
• Vascular Imaging

Background:

• Hepatic artery embolization (HAE) is a palliative treatment for inoperable liver tumors.
• Tumor neovascularization can lead to atypical arterial supply, complicating HAE.
• Internal mammary arteries (IMAs) may provide collateral supply to anteriorly located hepatic lesions.

Purpose of the Study:

• To prospectively identify patients with internal mammary artery (IMA) supply to hepatic tumors.
• To evaluate the role of IMA embolization as part of palliative hepatic artery embolization (HAE).

Main Methods:

• 222 patients with inoperable liver tumors underwent HAE over 4 years.
• Abdominal CT and hepatic arteriography were performed prior to embolization.
• IMA arteriography was performed for anterior subcapsular tumors identified on CT.

Main Results:

• Six patients had anterior subcapsular hepatic tumors identified on CT.
• All six patients demonstrated IMA supply to their tumors.
• All identified IMAs supplying the tumors were successfully embolized.

Conclusions:

• IMA supply to hepatic tumors is common in anterior subcapsular locations.
• Routine examination and potential embolization of IMA branches should be considered in HAE protocols for such lesions.