The History of Transarterial Therapies and Hepatic Arterial Infusion

The development of modern hepatic arterial infusion (HAI) is presented through the historical evolution of surgery and chemotherapy. This chapter demonstrates how this occurred via the advancement and convergence of multiple fields of medicine. As anatomic knowledge of the liver progressed, major hepatic resections followed and were ultimately limited by unresectable disease. Early experiences with chemotherapy for palliation of unresectable hepatic disease led to arterial infusion in the attempt to mitigate their detrimental systemic effects. Eventually the development of an implantable and more reliable delivery system led to larger studies and the first randomized trials. With 50 years of experimentation with regional therapy, the indications for HAI continue to evolve.