Balloon Occlusion of Internal Iliac Arteries in Management of Morbidly Adherent Placenta: Initial Experience at Our Centre

Abstract

superior mesenteric and gastroduodenal arteries. Suspect ECS in large subcapsular tumors with exophytic growth, adjacent organ invasion, hypertrophied extrahepatic collaterals and marginal recurrence abutting the liver capsule after TACE or local ablation. During TACE, no or incomplete tumor blush on selective hepatic arterial run, or defect in lipiodol deposition in the mass suggest ECS. Search for ECS is mandatory if follow up imaging shows peripheral defect in lipiodol deposition or enhancing residual component of primary mass. An alternative treatment should be undertaken if TACE through ECS fails. Conclusion(s):ECS is common in HCC at initial presentation and increases with repeated TACE sessions. For achieving complete tumor response, active search for signs of ECS should be done before, during and after TACE.