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Review
. 2015 Mar;32(1):22-5.
doi: 10.1055/s-0034-1396960.

Skin Necrosis Resulting from Nontarget Embolization of the Falciform Artery during Transarterial Chemoembolization with Drug-Eluting Beads

Mitchell T Smith  1 , David Thor Johnson  1 , Matthew G Gipson  1
Affiliations
Review

Skin Necrosis Resulting from Nontarget Embolization of the Falciform Artery during Transarterial Chemoembolization with Drug-Eluting Beads

Mitchell T Smith et al. Semin Intervent Radiol. 2015 Mar.

Abstract

Intra-arterial embolic therapies are a mainstay of liver-directed therapies to palliate symptoms, improve survival, and bridge patients to transplantation. Vascular anatomy and type of embolic used can lead to complications of nontarget embolization with varying clinical consequences. This case report describes a rare, nontarget embolization of the falciform artery leading to supraumbilical skin necrosis.

Keywords: chemoembolization; complication; embolization; interventional radiology; nontarget embolization.

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Figures

Fig. 1
Fig. 1
(a, b) Axial dynamic MRI images demonstrate two hemangiomas in the right hepatic lobe and a stellate lesion spanning segments 2, 3, and 4A corresponding to the patient's known HCC (arrows).
Fig. 2
Fig. 2
Angiogram via a coaxial microcatheter in the left hepatic artery demonstrating peripheral tumoral enhancement and contrast pooling, compatible with HCC-related neovascularity.
Fig. 3
Fig. 3
Photograph of the patient's periumbilical region showing the small ovoid bumps with a small area of skin ulceration.
Fig. 4
Fig. 4
Postembolization CT demonstrating good tumoral response with lack of enhancement in the central portion of the tumor with persistent contrast enhancement along the periphery compatible with viable tumor (arrowheads).
Fig. 5
Fig. 5
Same image as Fig. 2, demonstrating diagonal vessel from the left hepatic artery corresponding to the falciform artery (arrowheads).
See this image and copyright information in PMC

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