Proximal versus peripheral hepatic artery embolization experimental study in monkeys.

A case is described in which extensive embolization of the hepatic artery to reduce insulin production by a metastatic islet-cell tumor resulted in liver failure, intrahepatic abscesses, and death. The difference between proximal and peripheral hepatic artery obstruction was investigated in monkeys by embolizing hepatic arterial beds with Gelfoam and silicone. Gelfoam obstructed proximally, arterial collaterals developed rapidly, and liver function remained normal. Peripheral hepatic artery embolization with silicone produced liver infarction and severe functional abnormalities. Peripheral hepatic artery occlusion was more effective in preventing the development of collateral circulation but involved a significant risk of hepatic failure or abscess.