Mildly hypervascular focal lesion in segment 2/3 requiring infusion system placement on a curve in a second order branch of the Left Hepatic Artery (LHA).
An RDC sheath was used for access into the celiac axis. A Simmons 2 used to aid the tracking of the sheath. The Surefire Guide Sheath was advanced into a second order branch of the LHA which infused segments 2 and 3, then the Surefire Microcatheter expandable tip was deployed. LC-Bead (Biocompatibles/BTG) mixed with doxorubicin and contrast agent was infused. Following infusion in the LHA, the expandable tip was captured. Complete infusion was achieved in the target vessel. Tumor was only mildly hypervascular by angiography, DynaCT, and CT. Despite this, it retained iodinated contrast given with the DEBs. At the three week follow-up after the procedure, alpha-fetoprotein (AFP) level dropped from 3468 to 345 (90% decrease).
Target Vessel Diameter
LC Bead™ (Biocompatibles)
Cordis RDC 7Fr OD, 45 cm
Angiogram of the vascular anatomy. A) Sim 2 catheter to engage the celiac axis shows tortuous anatomy. B) The Left Hepatic Artery (LHA) branches perfuse a focal lesion in segments 2 and 3 of the liver.
Sub-selective Left Hepatic Artery infusion. The Surefire expandable tip is located at the target location in a second order branch of the LHA. Early infusion of a mix of drug-eluting beads and contrast agent showed enhancement in large vessels without tumor staining.
Full dose administered. The tumor exhibited significant staining (short arrows). No reflux was observed during infusion.