Transarterial radioembolization (TARE) is a 2-stage procedure involving a simulation phase and a treatment phase. The initial phase aims to define hepatic arterial anatomy, tumor-feeding vessels, and variations, and to perform technical simulation for the treatment phase. The treatment phase involves the administration of Yttrium-90 (Y-90)-loaded microspheres. This report presents a 60-year-old man with cholangiocarcinoma, exhibiting a rare variation of a distal esophageal artery originating from the hepatic artery, detected using contrast-enhanced Cone-Beam CT during the simulation phase. SPECT after 99mTc MAA injection confirmed extrahepatic accumulation in the distal esophagus and gastric cardia.