Fig 1.
The right gastric artery (Fig 1a; arrow) was identified and coilembolized (Fig 1b). SPECT/CT (Fig 1c) did not reveal extrahepatic tracer deposition.
Fig 2.
Initial DSA did not reveal any shunt vessels (Fig 2a). However, 99mTc-HSA scan revealed extrahepatic tracer uptake at the gastroduodenal junction (Fig 2b). A shunt vessel was identified during repeated DSA and occluded (Fig 2c) and no extrahepatic 99mTc-HSA deposition was seen anymore (Fig 2d).
Fig 3.
During the initial DSA the gastroduodenal artery and right gastric artery were occluded. However, a small branch to the small bowel arising from the right hepatic artery was missed (Fig 3a) resulting in an extrahepatic 99mTc-HSA deposition in the small bowel wall (Fig 3b). During repeated angiography the microcatheter was positioned in a more distal part of the right hepatic artery (Fig 3c). Subsequent SPECT/CT did not reveal any extrahepatic tracer accumulation (Fig 3d).