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Coil Embolization of Variant Hepatic Arteries During Percutaneous Arterial Port Catheter Placement for Intraarterial Chemotherapy: Analysis of Intrahepatic Perfusion Redistribution and Treatment Efficacy

  • Clinical Investigation
  • INTERVENTIONAL ONCOLOGY
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

Purpose

The purpose of this study was to analyze the intrahepatic perfusion redistribution after embolization of hepatic arterial variants during percutaneous arterial port catheter placement as well as to investigate the treatment efficacy of intraarterial chemotherapy in perfusion redistribution-dependent compared to redistribution-independent liver areas.

Materials and Methods

This retrospective study included 62 patients (67.7% males, mean age of 56 ± 12 years). A replaced left hepatic artery was encountered in 36/62 (58.1%), a replaced right hepatic artery in 19/62 (30.6%) and a replaced left and right hepatic artery in 7/62 of patients (11.3%), respectively. Subjective perfusion analysis was performed on digital subtracted angiography and computed tomography (CT)/cone-beam computed tomography (CBCT) images evaluating the visibility of the main, segmental and subsegmental branches of the embolized variant hepatic artery, re-perfused from intrahepatic arterial anastomoses. For objective perfusion analysis ROI measurements on CT/CBCT images were taken in the redistribution-dependent and redistribution-independent liver lobe. Response analysis according to RECIST 1.1 was separately calculated for the redistribution-dependent and redistribution-independent liver lobe.

Results

Intrahepatic reperfusion of the embolized variant hepatic artery was observed immediately after embolization with visualization of the subsegmental branches in 95.2% of patients. ROI measurements on CT/CBCT images (right lobe mean 76 ± 30.2 HU, left lobe mean 74.4 ± 30.5, p-value 0.88) did not show any differences. Treatment response after intraarterial chemotherapy did not differ between the redistribution-dependent and redistribution-independent liver lobes.

Conclusion

Embolization of hepatic arterial variants during percutaneous arterial port catheter placement results in effective intrahepatic perfusion redistribution and does not compromise treatment efficacy of intraarterial chemotherapy in the redistribution-dependent liver lobe.

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Abbreviations

AE:

Adverse event

CT:

Computed tomography

CBCT:

Cone-beam computed tomography

DSA:

Digital subtraction angiography

HAIC:

Hepatic arterial infusion chemotherapy

HU:

Hounsfield unit

MRI:

Magnetic resonance imaging

ROI:

Region of interest

SPECT:

Single-photon emission computed tomography

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Funding

This study was not supported by any funding.

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Authors and Affiliations

  1. Department of Interventional Radiology, Gustave Roussy Cancer Center, 114 Rue Edouard Vaillant, 94805, Villejuif, France

    Adrian Kobe, Frédéric Deschamps, Louis Meyblum, Eloi Varin, Alexandre Delpla, Antoine Hakime, Christophe Teriitehau, Charles Roux, Thierry de Baère & Lambros Tselikas

  2. Department of Medical Oncology, Gustave Roussy Cancer Campus, Villejuif, France

    Alice Boileve

  3. Department of Surgical Oncology, Gustave Roussy Cancer Campus, Villejuif, France

    Massimiliano Gelli

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  1. Adrian Kobe
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Correspondence to Adrian Kobe.

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Kobe, A., Deschamps, F., Meyblum, L. et al. Coil Embolization of Variant Hepatic Arteries During Percutaneous Arterial Port Catheter Placement for Intraarterial Chemotherapy: Analysis of Intrahepatic Perfusion Redistribution and Treatment Efficacy. Cardiovasc Intervent Radiol 46, 69–79 (2023). https://doi.org/10.1007/s00270-022-03303-y

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