Fig. 2.

Hepatocellular carcinoma treatment using implantable port-catheter system with our simplified fixed-catheter-tip method. 72-year-old man with advanced hepatocellular carcinoma and left portal vein invasion. Transarterial chemoembolization was performed 1-week before procedure.

A. Superior mesenteric artery angiography was performed using 5-Fr catheter with nonvisualization of left portal vein (arrows) because of tumor invasion.

B. Celiac angiography revealed extensive tumor staining (black arrows) involving left hepatic lobe. Previously treated region of hepatocellular carcinoma involving left lateral segment was not stained (white arrows).

C. 5-Fr indwelling catheter with side hole was inserted in right common femoral artery. Tip of catheter was wedged into proximal portion of right gastroepiploic artery. No additional distal tip-fixation material, such as coil or n-butyl cyanoacrylate, was used. Location of side hole was confirmed by test injection of contrast media, and proper hepatic artery (arrow) was opacified.

D. 6-month follow-up angiography revealed that location of indwelling catheter was not changed, and hepatic artery (arrow) was patent.