Extrahepatic Collateral Artery Extravasation in Patients with Ruptured Hepatocellular Carcinoma

J Vasc Interv Radiol. 2018 Apr;29(4):564-567. doi: 10.1016/j.jvir.2017.09.026.

Abstract

This report describes 3 patients with previously untreated hepatic tumors who underwent embolization for the treatment of extravasation from extrahepatic arteries. Although development of extrahepatic collateral blood supply is well known, its importance in the presentation of rupture of liver tumors may be underrecognized. Findings that suggest bleeding from extrahepatic arteries include a discrepancy in the pattern of extravasation on computed tomography vs hepatic angiography and a lack of stabilization of vital signs after embolization of hepatic arteries. To achieve successful hemostasis in embolization, the potential involvement of such extrahepatic arteries should be accurately recognized, suggestive imaging findings considered, and the occult vessels selected and embolized.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Carcinoma, Hepatocellular / diagnostic imaging*
  • Carcinoma, Hepatocellular / pathology*
  • Carcinoma, Hepatocellular / therapy
  • Collateral Circulation*
  • Contrast Media
  • Embolization, Therapeutic / methods
  • Extravasation of Diagnostic and Therapeutic Materials / diagnostic imaging*
  • Female
  • Hepatic Artery / pathology*
  • Humans
  • Liver Neoplasms / diagnostic imaging*
  • Liver Neoplasms / pathology*
  • Liver Neoplasms / therapy
  • Male
  • Middle Aged
  • Rupture, Spontaneous
  • Tomography, X-Ray Computed

Substances

  • Contrast Media