Hepatic Carcinoma with Blood Supply from the Omental Artery Treatment with Transcatheter Arterial Chemoembolization

Objective To study blood supply from the omental artery to hepatic carcinoma and evaluate the efficacy and safety of transcatheter arterial chemoembolization(TACE)via omental artery.Methods 19 cases of hepatic tumor fed by the omental artery underwent TACE of the omental artery.The omental branch angiographic features,tumor location,clinical observation,laboratory tests,imageology were evaluated,and finally were correlated with the angiographic findings of the omental branch.Results The tumor was located at the surface of the right lobe of the liver in 16 patients and at the lower edge of segment 4 in three patient.29 omental branches that fed HCC were observed angiographically.15omental branches(78.9%)could be successfully embolized.Hepatic hemostasis was achieved in all patients with ruptured HCC.Tumor recurred in 71%of patients who underwent successful TACE of the omental branch.Severe complications were not observed in any patient.Conclusion The omental artery collateral supply to HCC occur in HCCs located on the surface of the right lobe of the liver and in patients who have undergone multiple TACE procedures in the past.TACE of the omental artery is safe and has become technically feasible in almost all patients,although the tumor recurrence rate is extremely high.