Maria del Pilar Bayona Molano, Adam Swersky, Bradley Fox, Jay Vasani, Jason Salsamendi and Shivank Bhatia
Trans-arterial chemoembolization is a well-supported treatment option for patients with hepatocellular carcinoma who are not surgical or transplant candidates. The efficacy relies on the ability catheterize the arteries directly feeding a tumor and inject chemo-embolic particles directly into the tumor under fluoroscopic guidance. In the presence of a vascular anomaly such as an arterio-portal or arteriohepatic shunts, the flow dynamics within the tumor are altered and may compromise conventional or drug-eluting bead trans-arterial chemoembolization. We present the case of a patient with hepatocellular carcinoma complicated by arterio-portal and arterio-hepatic vein shunts who was treated with a modified trans-arterial chemoembolization utilizing balloon-occlusion.
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