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Jae Hyung Park

Publications and source records attributed to Jae Hyung Park.

At least 19 recordsLinked to original sources
PubMed2007

Internal mammary arteries supplying hepatocellular carcinoma: vascular anatomy at digital subtraction angiography in 97 patients.

PURPOSE: To retrospectively evaluate the vascular anatomy of the internal mammary arteries that supply hepatocellular carcinomas (HCCs), with an emphasis on number of tumor feeders. MATERIALS AND METHODS: This retrospective study was approved by the institutional review board; informed consent was waived. Between August 1996 and July 2005, internal mammary arteries that supply HCCs were found in 97 (2.2%) of 4438 patients (76 men, 21 women; mean age, 55 years +/- 10.5 [standard deviation]; range, 19-79 years). Computed tomographic scans and digital subtraction angiograms in these 97 patients were retrospectively reviewed in consensus by two interventional radiologists. Tumor size, number of tumor feeders, and tumor location were recorded. The t test and analysis of variance were used to correlate tumor size with number of tumor feeders, tumor feeder laterality, and transcatheter arterial chemoembolization (TACE) time. RESULTS: The following 125 tumor feeders were identified in 97 patients: phrenic branch (n = 59), musculophrenic artery (n = 40), superior epigastric artery (n = 15), anterior intercostal artery (n = 6), ensiform artery (n = 4), and pericardiacophrenic artery (n = 1). In two patients, tumors were in dorsal hepatic areas directly beneath the diaphragm. Half of the tumors located in liver segments II or III were supplied by the right internal mammary artery. In three patients, the tumor feeders from the left internal mammary artery crossed the midline. Tumor size was not statistically associated with number of tumor feeders (P = .076), tumor feeder laterality (P = .141), and TACE time (P = .729). CONCLUSION: The common tumor feeders of the internal mammary artery are the phrenic branch and the musculophrenic artery. Moreover, the internal mammary artery can supply a tumor even in the dorsal hepatic area.

Adult↗
PubMed2007

Local toxicity of hepatic arterial infusion of hexokinase II inhibitor, 3-bromopyruvate: In vivo investigation in normal rabbit model.

RATIONALE AND OBJECTIVES: 3-Bromopyruvate (3-BrPA), an hexokinase II inhibitor, is known to have high necrotic rate in hyperglycolytic liver tumor models without apparent damage to the normal liver parenchyma. The toxicity of intra-arterial delivery of 3-BrPA in various concentrations has not been specifically investigated using a normal rabbit model. MATERIALS AND METHODS: Twenty rabbits treated with intra-arterial 3-BrPA were divided into four groups according to its dose and infusion level: 1 mM at the left hepatic artery (group I), 5 mM at the left hepatic artery (group II), 25 mM at the left hepatic artery (group III), and 25 mM at the common hepatic artery (group IV). After selective catheterization, 30 ml of 3-BrPA was infused for 2 minutes. As a control group, five rabbits were treated with normal saline. During 1-week follow-up, toxicities were evaluated with blood laboratory results, mortality, and histopathologic examination. RESULTS: All 10 rabbits treated with 25 mM 3-BrPA and 2 rabbits treated with 5 mM 3-BrPA died within 3 days after treatment. In 10 of the 12 deaths, hemorrhagic pyloric or duodenal necrosis was noted. Hepatotoxicities on blood laboratory results were dose dependent but transient in the surviving rabbits. CONCLUSION: Selective intra-arterial administration of 25 mM 3-BrPA can cause considerable toxicities not only in the liver but also in the gastrointestinal system and are dose dependent and can cause death in high doses.

Animals↗
PubMed2006

The short-term effects on restenosis and thrombosis of echinomycin-eluting stents topcoated with a hydrophobic heparin-containing polymer.

Although drug-eluting stents (DESs) have become the most effective means of treating coronary artery disease, safety concerns regarding their thrombogenicities remain to be surmounted. Here, we report on a novel type of DES capable of preventing restenosis and thrombosis. The DES was prepared by coating a bare metal stent with echinomycin (an anti-proliferative drug) in polyurethane by a spray drying method. Hydrophobic heparinized polymer was then topcoated onto stent over echinomycin/PU layer by dipping to improve hemocompatibility. The two-layered stent was characterized regarding surface and cross-sectional morphology, drug release pattern, platelet adhesion in vitro, and restenosis in vivo. It was found that the heparin topcoat acts as a diffusion barrier that allows the controlled release of drug in a sustained manner. Also, the heparin coated layer effectively reduced platelet adhesion, indicating excellent hemocompatibility. From the animal test using pigs, it was evident that the developed DESs can minimize neointimal proliferation and thrombus formation. The devised hydrophobic heparinized polymer-coated DES effectively reduced both restenosis and thrombosis, suggesting that they have potential as tools for the treatment of coronary artery diseases.

Animals↗
PubMed2006

Intraarterial gene delivery in rabbit hepatic tumors: transfection with nonviral vector by using iodized oil emulsion.

PURPOSE: To evaluate the feasibility of an iodized oil emulsion that is used for the chemoembolization of hepatocellular carcinoma as a modifier of a nonviral gene transfer system for intraarterial gene delivery in experimentally induced hepatic tumors. MATERIALS AND METHODS: Experiments were performed in accordance with National Institutes of Health guidelines for the care and use of laboratory animals and were approved by the animal research committee at Seoul National University Hospital. VX2 carcinoma was implanted into the liver of 26 rabbits. Four nonviral gene transfer systems were prepared by using pCMV-luc+ as a reporter gene. The first system consisted of a DNA and polyethylenimine (PEI) complex (n = 7); the second, of a DNA and PEI complex mixed with iopamidol and iodized oil (n = 7); the third, of a DNA and PEI complex mixed with iopamidol (n = 7); and the fourth, of a DNA and PEI complex mixed with iodized oil (n = 5). For the DNA and PEI complex that was mixed with iopamidol and iodized oil, iopamidol was used to stabilize the emulsion. Twenty days after tumor implantation, intraarterial gene delivery was performed by selective catheterization of the hepatic artery. Rabbits were euthanized 24 hours after gene delivery. Luciferase activity was assayed in the tumor, left hepatic lobe, right hepatic lobe, and other organs and was statistically analyzed for comparison between complexes by using the Kruskal-Wallis test. RESULTS: Luciferase activity in the tumor was significantly higher for the group that received DNA, PEI, iopamidol, and iodized oil than for any other group (Kruskal-Wallis test, P < .05). Luciferase activity in the left hepatic lobe, right hepatic lobe, and other organs was not significantly different between complexes. Selective gene expression in tumor cells was confirmed by means of immunohistochemical analysis for luciferase. CONCLUSION: It is feasible to use an iodized oil emulsion system for the intratumoral transfection of nonviral vectors in experimentally induced hypervascular hepatic tumors.

Animals↗
PubMed2006

Myeloperoxidase -463G>A polymorphism and risk of primary lung cancer in a Korean population.

BACKGROUND: Myeloperoxidase (MPO) contributes to pulmonary carcinogenesis through activation of a wide range of tobacco smoke procarcinogens, including benzo[a]pyrene and aromatic amines. A -463G>A polymorphism in the promoter region of the MPO gene has been shown to reduce MPO expression and activity. It is therefore possible that carriers of the -463A allele may be at decreased risk of lung cancer. To test this hypothesis we have investigated the association between the -463G>A polymorphism of MPO gene and the risk of lung cancer in a Korean population. METHODS: The MPO genotype was determined in 432 lung cancer patients and 432 healthy controls that were frequency-matched for age and gender. RESULTS: In the current study, the risk estimate for lung cancer of the combined -463 AA+GA genotype was not significantly different from that of the -463GG genotype (adjusted OR=1.03, 95% CI=0.72-1.47). In addition, we observed no evidence of effect modification by age, gender, smoking history or tumor histology. CONCLUSIONS: These results suggest that the MPO -463G>A polymorphism does not significantly affect the susceptibility to lung cancer in Koreans.

Aged↗
PubMed2006

Polymorphisms in TGF-beta1 gene and the risk of lung cancer.

BACKGROUND: Transforming growth factor-beta1 (TGF-beta1) functions as a suppressor of tumor initiation by inhibiting cellular proliferation or by promoting cellular differentiation or apoptosis in the early phase of cancer development. Variations in the DNA sequence in the TGF-beta1 gene may lead to altered TGF-beta1 production and/or activity, and so this can modulate an individual's susceptibility to lung cancer. To test this hypothesis, we investigated the association of the TGF-beta1 -509C > T and 869T > C (L10P) polymorphisms and their haplotypes with the risk of lung cancer in a Korean population. METHODS: The TGF-beta1 genotypes were determined in 432 lung cancer patients and in 432 healthy control subjects who were frequency-matched for age and gender. The TGF-beta1 haplotypes were predicted using a Bayesian algorithm in the Phase program. RESULTS: Individuals with at least one -509T allele were at a significantly decreased risk of adenocarcinoma (AC) and small cell carcinoma (SM), as compared with carriers with the -509CC genotype [adjusted odds ratio (OR), 0.63; 95% confidence interval (CI), 0.42-0.96; P = 0.04; and adjusted OR, 0.45; 95% CI, 0.27-0.76; P = 0.002; respectively]. For the 869T > C polymorphism, the combined TC + CC genotype was associated with a significantly decreased risk of SM compared with the TT genotype (adjusted OR, 0.52; 95% CI, 0.31-0.88; P = 0.01). Consistent with the results of the genotyping analyses, the -509T/869C haplotype was associated with a significantly decreased risk of AC and SM as compared with the -509C/869T haplotype (adjusted OR, 0.75; 95% CI, 0.57-0.98; P = 0.04; and adjusted OR, 0.67; 95% CI, 0.47-0.96; P = 0.02; respectively). CONCLUSION: The TGF-beta1 -509C > T and 869T > C polymorphisms and their haplotypes may contribute to genetic susceptibility to AC and SM of the lung.

Adenocarcinoma↗
PubMed2006

Hydrophobically modified glycol chitosan nanoparticles as carriers for paclitaxel.

Self-assembled nanoparticles based on hydrophobically modified glycol chitosan (HGC) were prepared as a carrier for paclitaxel. HGC conjugates were prepared by chemically linking 5beta-cholanic acid to glycol chitosan chains using 1-ethyl-3-(3-dimethylaminopropyl)-carbodiimide chemistry. In phosphate-buffered saline (PBS; pH 7.4), the synthesized HGC conjugates formed nano-sized particles with a diameter of 200 nm and exhibited high thermodynamic stability as reflected by their low critical aggregation concentration (0.03 mg/ml). Paclitaxel was efficiently loaded into HGC nanoparticles up to 10 wt.% using a dialysis method. The paclitaxel-loaded HGC (PTX-HGC) nanoparticles were 400 nm in diameter and were stable in PBS for 10 days. These PTX-HGC nanoparticles also showed sustained release of the incorporated of paclitaxel (80% of the loaded dose was released in 8 days at 37 degrees C in PBS). Owing to sustained release, the PTX-HGC nanoparticles were less cytotoxic to B16F10 melanoma cells than free paclitaxel formulated in Cremophor EL. Injection of PTX-HGC nanoparticles into the tail vein of tumor-bearing mice prevented increases in tumor volume for 8 days. Finally, PTX was less toxic to the tumor-bearing mice when formulated in HGC nanoparticles than when formulated with Cremophor EL.

Animals↗
PubMed2006

O6-alkylguanine-DNA alkyltransferase gene polymorphisms and the risk of primary lung cancer.

O6-alkylguanine-DNA alkyltransferase (AGT) plays an important role in the repair of O6-alkylguanine adducts, which are major mutagenic lesions produced by environmental carcinogens. Polymorphisms in the AGT gene may affect the capacity to repair DNA damage and thereby have influence on individual's susceptibility to smoking-related cancer. To test this hypothesis, we investigated the potential association of AGT polymorphisms (485C > A, Leu53Leu (C > T) and Leu84Phe] with the risk of lung cancer in a Korean population. The AGT genotypes were determined in 432 lung cancer patients and in 432 healthy controls who were frequency-matched for age and gender. The 485 AA genotype was associated with a significantly increased risk for overall lung cancer as compared with the 485 CC genotype and the combined 485 CC + CA genotype, respectively (adjusted odds ratio (OR) = 1.83, 95% confidence interval (CI) = 1.12-2.99, P = 0.02, and Bonferroni corrected P-value (Pc) = 0.04; and adjusted OR = 1.67, 95% CI = 1.05-2.66, P = 0.03, respectively). When the lung cancer cases were categorized by the tumor histology, the 485 AA genotype was associated with a significantly increased risk of adenocarcinoma (AC) and small cell carcinoma (SmCC), respectively, as compared with the combined 485 CC + CA genotype (adjusted OR = 2.54, 95% CI = 1.39-4.66, P = 0.003; and adjusted OR = 2.19, 95% CI = 1.06-4.55, P = 0.04, respectively). However, the genotype distributions of the Leu53Leu and Leu84Phe polymorphisms were not significantly different between the lung cancer cases and the controls. On a promoter assay, the 485C > A polymorphism did not have an effect on the promoter activity of the AGT gene. These results suggest that the effect of the AGT 485C > A polymorphism on the risk of lung cancer may be secondary to linkage disequilibrium (LD) with either another AGT variant or with a true susceptibility gene, and that the AGT 485C > A polymorphism could be used as a marker for the genetic susceptibility to lung cancer.

Adenocarcinoma↗
PubMed2006

Self-assembled nanoparticles based on glycol chitosan bearing hydrophobic moieties as carriers for doxorubicin: in vivo biodistribution and anti-tumor activity.

Self-assembled nanoparticles, formed by polymeric amphiphiles, have been demonstrated to accumulate in solid tumors by the enhanced permeability and retention effect, following intravenous administration. In this study, hydrophobically modified glycol chitosans capable of forming nano-sized self-aggregates were prepared by chemical conjugation of fluorescein isothiocyanate or doxorubicin to the backbone of glycol chitosan. Biodistribution of self-aggregates (300 nm in diameter) was evaluated using tissues obtained from tumor-bearing mice, to which self-aggregates were systemically administered via the tail vein. Irrespective of the dose, a negligible quantity of self-aggregates was found in heart and lung, whereas a small amount (3.6-3.8% of dose) was detected in liver for 3 days after intravenous injection of self-aggregates. The distributed amount of self-aggregates gradually increased in tumor as blood circulation time increased. The concentration of self-aggregates in blood was as high as 14% of dose at 1 day after intravenous injection and was still higher than 8% even at 3 days. When self-aggregates loaded with doxorubicin were administered into the tumor-bearing mice via the tail vein, they exhibited lower toxicity than but comparable anti-tumor activity to free doxorubicin. These results revealed the promising potential of self-aggregates on the basis of glycol chitosan as a carrier for hydrophobic anti-tumor agents.

Animals↗
PubMed2006

Nonhepatic arteries originating from the hepatic arteries: angiographic analysis in 250 patients.

PURPOSE: To investigate the prevalence and patterns of origin of nonhepatic arteries originating from the proper hepatic artery (PHA) or its distal branches and to assess their relation to anatomic variations. MATERIALS AND METHODS: Digital subtraction celiac arteriography and selective left hepatic arteriography was performed in 250 patients with hepatocellular carcinoma. Three interventional radiologists interpreted the angiograms on the monitor by consensus. If necessary, further superselective arteriography was performed. The prevalence of nonhepatic arteries, their sites of origin, and the influence of underlying anatomic variants were analyzed. RESULTS: Nonhepatic arteries were found in 205 patients. The most common nonhepatic artery was the right gastric artery (RGA; n = 196), followed by the hepatic falciform artery (HFA; n = 129), accessory left gastric artery (LGA; n = 43), posterior superior pancreaticoduodenal artery (PSPDA; n = 18), and left inferior phrenic artery (LIPA; n = 5). The left hepatic artery (LHA) was the most frequent origin of nonhepatic arteries (170 of 250). Regardless of anatomic variation, the most common origins of the RGA and HFA were the PHA and the segment IV hepatic artery, respectively. In patients with an aberrant LHA from the LGA, no accessory LGAs or LIPAs were found. PSPDAs preferentially arose from variant hepatic arteries arising from the gastroduodenal artery. CONCLUSIONS: Nonhepatic arteries commonly arise from the hepatic arteries, especially the LHA and PHA. Moreover, variants of the celiac and hepatic arteries influence the prevalence and sites of origin of nonhepatic arteries.

Adult↗
PubMed2006

Hepatocellular carcinoma: transcatheter arterial chemoembolization of the gonadal artery.

Over the past 9 years, the authors have identified gonadal arteries supplying hepatocellular carcinoma in seven of 4,438 patients (0.16%) whom they attempted to treat by transcatheter arterial chemoembolization. All seven patients had tumors in the Couinaud segment 6 (S6) of the liver (mean size, 6.8 cm). The gonadal arteries in all seven patients showed anatomic variations, including a high origin (n = 3) and a common trunk with the adrenal artery (n = 4). The gonadal artery with anatomic variation may supply hepatocellular carcinomas located in liver S6.

Adult↗
PubMed2006

Urine attenuation ratio: A new CT indicator of renal artery stenosis.

OBJECTIVE: The purpose of our study was to evaluate the value of a ratio of the attenuation measurements of urine in each kidney (hereafter referred to as the urine CT attenuation ratio) in the detection and lateralization of significant renal artery stenosis (RAS). SUBJECTS AND METHODS: In 33 patients with suspected renovascular hypertension and 43 normotensive patients, 5-mm-thick transverse CT scans of the kidney area were obtained 4 min after helical CT angiography (CTA). The attenuation of urine in each kidney was measured, and its ratio was calculated. All 76 patients underwent intraarterial digital subtraction angiography within 2 days after the CT examination. The results of angiography were correlated with the urine attenuation ratio of both kidneys. RESULTS: Twenty-six patients showed significant RAS: unilaterally in 20 and bilaterally in six patients. Two patients showed moderate stenosis of renal arteries. The other patients with essential hypertension (n = 5) or normal blood pressure (n = 43) showed normal renal arteries. The CT attenuation of urine in each kidney was measured and its ratio calculated in all patients except four patients with unilateral RAS. The urine CT attenuation ratio in 22 patients with significant RAS ranged from 1.11 to 4.76 (mean, 2.07). The two patients with moderate RAS showed ratios of 1.83 and 1.23. The others (n = 48) had a urine CT attenuation ratio that ranged from 1.00 to 1.54 (mean, 1.07). The difference of the ratio between the RAS group and the normal group was statistically significant (p < 0.01). The mean urine CT attenuation ratio was 2.18 in patients with unilateral RAS (n = 16) and 1.75 in patients with bilateral RAS (n = 6). The difference of the ratio between the two groups was not statistically significant (p = 0.16). At a cutoff value of 1.22, the sensitivity, specificity, positive predictive value, and negative predictive value of the urine CT attenuation ratio in the diagnosis of significant RAS were 95%, 96%, 91%, and 98%, respectively. CONCLUSION: The urine CT attenuation ratio is a simple and reliable indicator with which to detect and lateralize significant RAS and is a useful adjunct to helical CTA.

Adult↗
PubMed2006

Technical feasibility and biocompatibility of a newly designed separating stent-graft in the normal canine aorta.

OBJECTIVE: The objectives of this study were to assess the performance of a newly designed separating stent-graft system with respect to the technical feasibility of transfemoral deployment, the maintenance of vessel patency, and stent deformity due to mechanical defects; and to evaluate its in vivo healing characteristics, including thrombus formation, and endothelial covering of the stent-graft when placed in the normal aorta of a canine model. CONCLUSION: The newly designed separating stent-graft allowed accurate deployment without migration. This animal study also provided an opportunity to examine the healing process associated with an ultrathin polyester fabric nitinol stent and showed predictable healing characteristics in the normal thoracic aorta in this canine model.

Animals↗
PubMed2006

Superficial venous aneurysm: reports of 3 cases and literature review.

OBJECTIVE: The purpose of this series is to describe the ultrasonographic and computed tomographic (CT) findings of superficial venous aneurysms sometimes misdiagnosed as subcutaneous soft tissue tumors. METHODS: Two of the patients had an asymptomatic subcutaneous mass that gradually increased in size; the third patient had a superficial mass in the right antecubital fossa associated with pain and occasional edema. All of the patients were examined with ultrasonography, and 2 had CT scans. RESULTS: In all cases, ultrasound examinations showed a well-defined heterogeneous echoic lesion that was contiguous with the adjacent superficial vein and easily compressed by the probe, whereas a Doppler study indicated a venous spectral wave without pulsation. Dynamic enhanced CT showed homogeneous enhancement in the late phase, with contiguity with the adjacent vein. Only the third patient had an internal, floating, heterogeneous, echoic mass-like lesion, suggesting a chronic thrombus in the lesion on ultrasonography. This patient underwent aneurysmectomy with end-to-end anastomosis. CONCLUSIONS: Venous aneurysm should be included in the differential diagnosis of a subcutaneous mass, and an accurate understanding of the differences between superficial and deep venous aneurysms may help in diagnosis and treatment.

Aneurysm↗
PubMed2005

Evaluation of absorption of heparin-DOCA conjugates on the intestinal wall using a surface plasmon resonance.

We validated the application of the surface plasmon resonance (SPR) technique to reliably determine adhesion of drugs to the intestinal wall using heparin-DOCA conjugates, developed to enhance the oral absorption of poorly absorbed heparin. In this study, heparin conjugates, or deoxycholyl-heparin (H-DOCA) and bisdeoxycholyl-heparin (H-bis-DOCA), were synthesized by covalently coupling the synthesized succinimido deoxycholate (DOCA-NHS) or succinimido bis-deoxycholyl-L-lysine (DOCA-bis-NHS) to amine groups of heparin, and their physicochemical and biological properties were evaluated. To mimic the duodenal and ileal surfaces, duodenal and ileal brush border membrane (BBM) vesicles isolated from Sprauge-Dawley (SD) rats were immobilized onto a biosensor chip composed of dextran derivatives with modified lipophilic residues. The adhesion of heparin conjugates on the BBM surface was evaluated by measuring the SPR response signal. The adhesion of heparin conjugates was significantly dependent on the conjugated DOCA molecules: that is, they showed higher adhesion signal on the ileal BBM surface than that on the duodenal BBM surface. In particular, the solubilized heparin conjugates in DMSO solution presented significantly increased adhesion affinity on the ileal BBM surface. The adhesion of heparin conjugates on the intestinal surfaces was successfully assayed using the surface plasmon resonance technique with the sensor chip on which BBM vesicles were immobilized.

Animals↗
PubMed2005

Role of computed tomographic angiography in the detection and comprehensive evaluation of persistent sciatic artery.

PURPOSE: To define the role of computed tomographic (CT) angiography in the evaluation of persistent sciatic artery and to identify its potential advantages as a diagnostic modality. METHODS: Between July 2002 and August 2004, 307 consecutive patients underwent CT angiography for suspected lower-extremity arterial insufficiency. All CT angiograms were retrospectively reviewed to determine the presence and laterality of persistent sciatic artery and its associated vascular abnormalities, such as aneurysm, thrombus, distal thromboembolism, and atherosclerotic change. The relationship of persistent sciatic artery with adjacent structures, such as sciatic nerve, muscle, accompanying vein, and femoral artery, as well as the presence of other anomalies, was analyzed. Clinical data regarding the presenting symptoms and hospital course were obtained from patient charts. RESULTS: Six persistent sciatic arteries, with or without occlusion, were identified in five female patients (age range, 54 to 80 years). CT angiography revealed unilateral persistent sciatic artery in four patients (left, 3; right, 1) and bilateral persistent sciatic artery in one patient. Aneurysm was present in two (mean size, 26 mm x 20 mm), thrombosis in three, and distal thromboembolism in all six persistent sciatic arteries. All persistent sciatic arteries coursed along the sciatic nerve and continued as popliteal artery. Characteristically, in all these instances, the superficial femoral arteries were hypoplastic and tapered smoothly. Anomalous popliteal venous drainage was noted in all ipsilateral limbs with persistent sciatic artery and even in contralateral limbs with normal superficial femoral artery in all but one. CONCLUSION: CT angiography enables the detection of persistent sciatic artery even in the presence of complete occlusion and is useful in the comprehensive evaluation of various complications and associated venous anomalies. It can potentially be used as the sole imaging modality for persistent sciatic artery.

Aged↗
PubMed2005

Recognizing extrahepatic collateral vessels that supply hepatocellular carcinoma to avoid complications of transcatheter arterial chemoembolization.

Extrahepatic collateral arteries commonly supply hepatocellular carcinomas if the tumors are large or peripherally located. Because development of these vessels interferes with effective control of the tumor with transcatheter arterial chemoembolization (TACE), radiologists should become familiar with the imaging findings of extrahepatic collateral vessels to detect them at an early stage. The authors observed 2104 such vessels in 860 patients over 5.5 years. The extrahepatic collateral vessels observed originated from the inferior phrenic artery, omental branch, adrenal artery, intercostal artery, cystic artery, internal mammary artery, renal or renal capsular artery, branch of the superior mesenteric artery, gastric artery, and lumbar artery. The authors suspected extrahepatic collateral vessels when (a) a tumor grew exophytically or invaded adjacent organs, (b) a tumor was in contact with the ligaments and bare area of the liver, (c) a hypertrophied extrahepatic collateral vessel was observed on a computed tomographic (CT) scan, (d) a peripheral defect of iodized oil retention within a tumor was seen during chemoembolization or on a follow-up CT scan, (e) a local recurrence developed at the peripheral portion of the treated tumor during follow-up, or (f) a sustained elevation in serum alpha-fetoprotein level was noted despite adequate embolization of the hepatic artery. When both the hepatic artery and extrahepatic collateral vessels supply a tumor, additional extrahepatic collateral vessel chemoembolization should be attempted to increase the therapeutic efficacy of TACE for hepatocellular carcinoma.

Adult↗