Hepatocellular carcinoma with blood supply from omental branches: Treatment with transcatheter arterial embolization

PURPOSE: To evaluate the usefulness of transcatheter arterial embolization (TAE) through the omental branch in the treatment of hepatocellular carcino ma (HCC) with blood supply from the omental branch. MATERIALS AND METHODS: Fifteen patients with HCC fed by the omental branch underwent TAE. All but one had previously undergone several therapies for H CC, including TAE, Three patients had intraperitoneal hemorrhage caused by ruptured HCC fed by the omental branch, and two necessitated emergency TAE. The technical success rate, therapeutic effect, and safety of TAE via the omental branch were evaluated. RESULTS: Twenty-six omental branches that fed HCC were observed angiographi cally. Attenuation or occlusion of the hepatic artery was observed in 80%. Nineteen omental branches (73%) could be successfully embolized. Hepatic he mostasis was achieved in all patients with ruptured HCC. Tumor recurred in 80% of patients who underwent successful TAE of the omental branch, and add itional therapy was performed in six patients. Ten patients died after 2-26 months (mean, 8 mo). Five patients were alive for 3-13 months (mean, 7 mo) . Severe complications were not observed in any patient. CONCLUSION: TAE of the omental branch is safe and has become technically fe asible in almost all patients, but tumors frequently recur.