Fig. 6. A 81-year-old male presented with hepatocellular carcinoma (HCC) in caudate lobe treated by triaxial microcatheter system. (A) The distal portion of triaxial microctheter system consists of a non-tapered 1.9-Fr microcatheter (open white arrow), a 2.6–2.9 Fr high-flow microcatheter (white arrow), and a 4-Fr Catheter (black arrow). A 0.014 inch micro guide wire can be inserted into this catheter system (white arrow head). (B) The contrast enhanced computed tomography (CT) image in arterial phase showed 6cm enhancement of HCC at the caudate lobe (arrow). (C) An accumulation of contrast material injected from the tip of the 4Fr catheter at the origin of the celiac artery was depicted. (D) In superior mesenteric arteriography, left hepatic artery (white open arrowhead) from common hepatic artery (white arrowhead), and splenic artery (white open arrow) which branch from the celiac artery via the pancreatic arcade and collateral tract of the dorsal pancreatic artery (white arrow), are depicted from the origin of right hepatic artery. (E) The tip of the triaxial microcatheter system was advanced to A4 via the dorsal pancreatic artery arising from superior mesenteric artery to splenic artery and common hepatic artery. The tip of a non-tapered 1.9-Fr microcatheter was at the axis of A4 (white open arrow) and the tip of high-flow microcatheter was at the dorsal pancreatic artery (white arrow). (F) Contrast-enhanced CT images after treatment with 3 transarterial chemoinfusion (TAI) and 4 combined TAI and transarterial embolization showed shrinkage of HCC in the caudate lobe.
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