Intra- and Extrahepatic Collaterals: Pitfalls and Pathways for Locoregional Therapy

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Abstract
Intra-arterial interventions are increasingly performed for several other primary and metastatic liver tumors including hepatocellular carcinoma (HCC), cholangiocarcinoma, neuroendocrine tumor, colorectal cancer, uveal melanoma, and other less common entities.[1] [2] [3] [4] Understanding common patterns of extrahepatic collateral supply to metastases is vital in patients with bulky disease, especially following multiple treatment sessions with resulting arteriopathy with tumors in anatomically relevant locations. With the advent of radioembolization and the recognized risk of radiation-induced ulcer, insight into other intrahepatic pathways is also valuable to identify less common sources of tumor supply and to avoid nontarget infusion of the stomach or skin via accessory supply to the right gastric or falciform arteries, respectively. In this review, we describe common patterns originating from outside the liver or from the hepatic arteries.

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