Rare constellation of abdominal vascular injuries in blunt trauma: Left gastric artery pseudoaneurysms and dissection

This case report describes the chemoembolization of a small hepatocellular carcinoma employing a lipiodol drug delivery system utilizing a novel arterial pathway. Because the target lesion was precariously located adjacent to the inferior heart border and the diaphragm, it was unsuitable for imaging-guided microwave ablation. To achieve chemoembolization, several intraprocedural adaptations were necessary, given the variant anatomy encountered and difficulty accessing the left gastric artery through a celiac artery approach. The left gastric artery was selected from a superior mesenteric artery approach through the pancreaticoduodenal arcade (Rio Branco’s arcade). This case illustrates the importance of a mastery of the vascular anatomy and variants of hepatic arterial flow.

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Prognostic impact of lymph node metastasis along the left gastric artery in esophageal squamous cell carcinoma

Journal of Cardiothoracic Surgery ◽

10.1186/s13019-021-01466-2 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Xuan Liu ◽

Leilei Wu ◽

Dongkun Zhang ◽

Peng Lin ◽

Hao Long ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Lymph Node ◽

Esophageal Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Cox Regression ◽

Left Gastric Artery ◽

Prognostic Impact ◽

Gastric Artery ◽

Term Survival

Abstract Background Although the incidence of lymph node (LN) metastasis (LNM) along the left gastric artery is high, its relationship with the prognosis in postoperative patients with esophageal squamous cell carcinoma (ESCC) is rarely reported. This study clarified the prognostic impact of LNM along the left gastric artery in postoperative patients with ESCC. Methods This study assessed data of 1521 patients with ESCC who underwent esophagectomy at the Sun Yat-sen University Cancer Center between March 1992 and March 2012. A chi-squared test and Mann-Whitney U test were used to explore the preliminary correlation between clinical factors and LNM along the left gastric artery. Univariate and multivariate Cox regression analyses were used to assess whether LNM along the left gastric artery was an independent predictor of overall survival. Kaplan–Meier analysis and the log-rank test were used to present a classifying effect based on LN status. Results LNM was observed in 598 patients (39.3%) and was found along the branches of the left gastric artery in 256 patients (16.8%). The patients were classified into two groups based on the presence of LNM along the left gastric artery. Patients without LNM along the left gastric artery had better cancer-specific survival than those with positive LNs (P < 0.001). Conclusions This study indicated that LNM along the left gastric artery was an important independent prognostic factor for long-term survival among ESCC patients (P = 0.011).

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Hemorrhagic Gastric Metastasis from Hepatocellular Carcinoma Successfully Treated Using Coil Embolization of the Left Gastric Artery

Internal Medicine ◽

10.2169/internalmedicine.2172-18 ◽

2019 ◽

Vol 58 (15) ◽

pp. 2179-2183

Author(s):

Michitaka Imai ◽

Toru Ishikawa ◽

Marina Okoshi ◽

Kei Tomiyoshi ◽

Yuichi Kojima ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Coil Embolization ◽

Left Gastric Artery ◽

Gastric Artery ◽

Gastric Metastasis

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The Features of Extrahepatic Collateral Arteries Related to Hepatic Artery Occlusion and Benefits in the Transarterial Management of Liver Tumors

Radiology Research and Practice ◽

10.1155/2013/535272 ◽

2013 ◽

Vol 2013 ◽

pp. 1-6

Author(s):

Lin Yang ◽

Xiao Ming Zhang ◽

Yong Jun Ren ◽

Nan Dong Miao ◽

Xiao Hua Huang ◽

...

Keyword(s):

Hepatic Artery ◽

Liver Tumors ◽

Left Gastric Artery ◽

Artery Occlusion ◽

Gastric Artery ◽

Collateral Arteries ◽

Hepatocellular Carcinomas ◽

Collateral Artery ◽

The Common ◽

The One

Purpose. To investigate the extrahepatic collateral arteries related to hepatic artery occlusion (HAO) and to determine its benefits in the transarterial management of liver tumors.Methods and Findings. Eleven patients (7 hepatocellular carcinomas, 3 liver metastases, and 1 with hemangioma) with HAO confirmed with digital subtraction angiography (DSA) were admitted to our hospital. Of the 11 patients, 7 were men and 4 were women, with an average age of 41.5 ± 15.5 years (range: 29 to 70 years). DSA was performed to evaluate the collateral routes to the liver. In the 11 patients with HAO, DSA showed complete occlusion of the common hepatic artery in 9 patients and the proper hepatic artery (PHA) in 2 patients. Extrahepatic collateral arteries supplying the liver were readily evident. The collateral arteries originated from the superior mesenteric artery (SMA) in 8 patients, from the gastroduodenal artery in 2 patients, and from the left gastric artery (LGA) in 1 patient. Transcatheter treatment was successfully performed via the collateral artery in all patients except the one who had hemangioma.Conclusions. DSA is an effective method for detecting collateral circulation related to HAO and may provide information to guide transcatheter management decisions.

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Distal subtotal gastrectomy with preservation of the left gastric artery and vagal branches

The American Journal of Surgery ◽

10.1016/s0002-9610(02)01426-5 ◽

2003 ◽

Vol 185 (4) ◽

pp. 395-396 ◽

Cited By ~ 1

Author(s):

Julian E. Losanoff ◽

Bruce W. Richman ◽

James W. Jones

Keyword(s):

Subtotal Gastrectomy ◽

Left Gastric Artery ◽

Gastric Artery

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Liver revascularization with the left gastric artery following portocaval shunt in rats: Technique and preliminary results

Microsurgery ◽

10.1002/micr.1920050304 ◽

1984 ◽

Vol 5 (3) ◽

pp. 119-122 ◽

Cited By ~ 3

Author(s):

P. Vassanelli ◽

R. Marchetto ◽

P. Marini ◽

D. Fiore

Keyword(s):

Left Gastric Artery ◽

Portocaval Shunt ◽

Gastric Artery ◽

Preliminary Results

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Abdominal vascular injuries- what general/ trauma surgeons should know

Journal of the Pakistan Medical Association ◽

10.47391/jpma.354 ◽

2021 ◽

pp. 1-12

Author(s):

Zia Ur Rehman

Keyword(s):

Abdominal Trauma ◽

Vena Cava ◽

Minimal Invasive ◽

Balloon Occlusion ◽

Surgical Approaches ◽

Haemodynamic Instability ◽

Vascular Injuries ◽

Operative Strategy ◽

Endovascular Interventions ◽

Abdominal Vascular Injuries

Abstract Abdominal vascular injuries are the common cause of death after abdominal trauma. These are challenging injuries to manage due to severe haemodynamic instability, associated injuries and difficulty in accessing and controlling these vessels. Early control of bleeding can decrease the mortality in these patients. Abdominal vasculature is divided in four zones and each zone need different operative strategy for exposure. Principles of proximal and distal control are followed before exploring any haematoma. Endovascular interventions (angioembolization, stent-graft) have shown improved outcomes in patients with blunt abdominal trauma. Resuscitative Endovascular Balloon Occlusion of Aorta is minimal invasive method of achieving aortic occlusion and acts as bridge for definitive intervention or surgery. Updated knowledge is necessary for all those directly involved in managing these patients. The current review discusses relevant anatomy, principles, different surgical approaches and endovascular techniques to deal these injuries. Keywords: Abdominal trauma; injury; aorta; inferior vena cava. Continuous....

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Left gastric artery pseudoaneurysm mimicking a giant gastric subepithelial lesion

Internal and Emergency Medicine ◽

10.1007/s11739-021-02881-y ◽

2021 ◽

Author(s):

Hung-Yi Chen ◽

Hsing-Hao Ho ◽

De-Chuan Chan ◽

Peng-Jen Chen ◽

Jung-Chun Lin

Keyword(s):

Left Gastric Artery ◽

Gastric Artery ◽

Artery Pseudoaneurysm ◽

Subepithelial Lesion

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Arterial diameter of the celiac trunk and its branches: anatomical study

Acta Cirurgica Brasileira ◽

10.1590/s0102-86502009000100009 ◽

2009 ◽

Vol 24 (1) ◽

pp. 43-47 ◽

Cited By ~ 28

Author(s):

Luís Augusto da Silveira ◽

Fernando Braga Cassiano Silveira ◽

Valéria Paula Sassoli Fazan

Keyword(s):

Hepatic Artery ◽

Celiac Trunk ◽

Anatomical Study ◽

Anatomical Variations ◽

Left Gastric Artery ◽

Gastric Artery ◽

Arterial Diameter ◽

Significant Difference ◽

Diameter Reduction ◽

Formalin Fixed

PURPOSE: Despite the fact that anatomical variations of the celiac trunk are well explored in the literature, information on these vessels diameters is scanty. The aims of the present study were to describe the arterial diameters of the celiac trunk and its main branches, and to investigate if these diameters are altered in those cases presenting anatomical variations of these vessels. METHODS: Twenty-one formalin fixed adult male cadavers were appropriately dissected for the celiac trunk identification and arterial diameter measurements. Arteries measured included the celiac trunk and its main branches (splenic artery, left gastric artery and common hepatic artery), as the proper hepatic artery, right gastric artery, the left and right hepatic arteries and the gastroduodenal artery. RESULTS: From the 21 cadavers, 6 presented anatomical variations of, at least, one of the above mentioned branches. The average arterial diameter comparisons between groups (normal and variable) clearly showed smaller diameters for variable vessels, but with no significant difference. CONCLUSION: Our data indicates the possibility of a diameter reduction of the celiac trunk main branches in the presence of anatomical variations. This should be taken into account on the selection for the liver transplantation donors.

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