Transarterial lipiodol-embolization of a left liver carcinoid metastasis from a right internal mammary artery approach

The purpose of this article is to illustrate the efficacy of the chemoembol ization in patients with hypervascular metastases and to describe the post- embolization change in vascularization pattern. Unusual collaterals may dev elop following embolization. A 59-year-old woman, followed for unresectable small bowel carcinoid tumor since 1991, underwent successful chemoemboliza tion of several liver metastases. Only one liver lesion, located in segment IV, showed interval increase in size. This lesion was supplied by the righ t internal mammary artery. A branch of the right internal mammary artery wa s catheterized using a microcatheter and embolization was performed using d oxorubicine-lipiodol (Adriblastine(R), Lipiodol(R)) and gelfoam (Spongel(R) ). No complications occurred after the procedure. The right internal mammar y artery should be considered as a possible source of collateral arterial s upply to the liver and should be evaluated in patients with local progressi on of disease.