Analysis of the origin of the right inferior phrenic artery in 178 patients with hepatocellular carcinoma treated by chemoembolization via the right inferior phrenic artery

2007 ◽  
Vol 48 (7) ◽  
pp. 728-733 ◽  
Author(s):  
S. Kimura ◽  
M. Okazaki ◽  
H. Higashihara ◽  
Y. Nozaki ◽  
M. Haruno ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Left Gastric Artery ◽  
Celiac Artery ◽  
Gastric Artery ◽  
Inferior Phrenic Artery ◽  
Pancreatic Artery ◽  
Phrenic Artery ◽  
The Right ◽  
Angiographic Findings ◽  
Arterial Chemoembolization

Background: No previous report has described the level of the origin of the right inferior phrenic artery (RIPA) based on an analysis of the relationships between the level of the RIPA, the celiac artery (CA), the superior mesenteric artery (SMA), and the right renal artery (RRA) in a series of cases. Purpose: To evaluate the origin of the RIPA by retrospectively analyzing angiographic findings in 178 patients with hepatocellular carcinoma (HCC) who underwent transcatheter arterial chemoembolization (TACE) via the RIPA. Material and Methods: In patients treated with intraarterial chemoembolization for HCC, additional superselective chemoembolization of the RIPA branches was necessary in 178 cases. We analyzed the level of the origin of the RIPA in these patients according to the relationships between the level of the origin of the RIPA, the CA, the SMA, and the RRA on angiography. Results: Among the 178 cases, the RIPA arose from 1) the aorta directly in 102 cases (57%), 2) the CA in 53 (30%), 3) the left gastric artery (LGA) in three (2%), 4) the dorsal pancreatic artery (DPA) in one (1%), and 5) the RRA in 19 (11%). The level of the origin of the RIPA that originated directly from the aorta was supraceliac in 56 cases (32%), between the CA and the SMA in 31 (17%), and between the SMA and the RRA in 15 (8%). Conclusion: In our study, the RIPA originated from the aorta between the CA and the SMA directly in 17% of cases. When it is difficult to identify the origin of the RIPA, we must keep in mind that the RIPA may originate from the right part of the aorta within the small distance between the SMA and the CA.

Diaphragmatic weakness after transcatheter arterial chemoembolization of the right inferior phrenic artery for treatment of hepatocellular carcinoma: a comparison of outcomes after N-butyl cyanoacrylate versus gelatin sponge embolization

2020 ◽  
pp. 028418512098177
Author(s):  
Seung Yeon Noh ◽  
Dong Il Gwon ◽  
Suyoung Park ◽  
Woo Jin Yang ◽  
Hee Ho Chu ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Complete Response ◽  
Gelatin Sponge ◽  
Inferior Phrenic Artery ◽  
Gelatin Sponge Particles ◽  
Phrenic Artery ◽  
The Right ◽  
Diaphragmatic Weakness ◽  
Arterial Chemoembolization

Background The inferior phrenic artery (IPA) is the most common extrahepatic feeder for hepatocellular carcinoma (HCC) during transhepatic arterial chemoembolization (TACE). Purpose To compare the incidence of diaphragmatic weakness in patients with HCC after TACE of the right IPA conducted using either N-butyl cyanoacrylate (NBCA) or gelatin sponge particles. Material and Methods Medical records of 111 patients who underwent TACE of the right IPA using NBCA were retrospectively reviewed and compared with data from 135 patients with IPA embolization using gelatin sponge particles. Results The incidence of diaphragmatic weakness after the initial TACE procedure did not significantly differ between the groups (NBCA group 16.2%; gelatin sponge group 20.7%; P = 0.458). Five patients in the NBCA group and 11 in the gelatin sponge group showed spontaneous resolution of diaphragmatic weakness after a mean period of 3.5 months. Diaphragmatic weakness developed after the initial follow-up visit in 17 patients from the gelatin sponge group due to repeated TACE of the right IPA (mean 2.4 sessions; range 2–4 sessions), while it spontaneously developed without additional TACE procedures in one patient from the NBCA group. Permanent diaphragmatic weakness was less common in the NBCA than in the gelatin sponge group (12.6% and 25.2%, respectively; P = 0.017). The complete response rate did not significantly differ between the groups (NBCA group 16.2%; gelatin sponge group 25.9%; P = 0.065). Conclusion Use of NBCA rather than gelatin sponge particles for TACE of the right IPA resulted in a lower incidence of permanent diaphragmatic weakness.

scholarly journals The origin of the inferior phrenic artery: a study in 32 South Indian cadavers with a review of the literature

2007 ◽  
Vol 6 (3) ◽  
pp. 225-230 ◽  
Author(s):  
Thejodhar Pulakunta ◽  
Bhagath Kumar Potu ◽  
Vasavi Rakesh Gorantla ◽  
Muddanna S. Rao ◽  
Sampath Madhyastha ◽  
...  
Keyword(s):  
Additional Data ◽  
Gross Anatomy ◽  
Celiac Trunk ◽  
Left Gastric Artery ◽  
Celiac Artery ◽  
Inferior Phrenic Artery ◽  
Medical College ◽  
South Indian ◽  
Phrenic Artery ◽  
The Right

BACKGROUND: Considering the paucity of information presently available concerning inferior phrenic arteries, a more definitive study seemed appropriate and necessary, both for its potential clinical applications and to provide additional data to contemporary anatomical literature. OBJECTIVE: Most anatomical textbooks of gross anatomy offer very little information concerning the anatomy and distribution of the inferior phrenic artery (IPA). For that reason, the origin of the IPA has been studied and the available literature has been reviewed. METHODS: Thirty-two human adult cadavers preserved in formalin obtained from the departments of Anatomy, Kasturba Medical College, Manipal and Mangalore were dissected and the origin of the IPA was studied. RESULTS: The IPA had its usual origin from the abdominal aorta in 28 cases but in the remaining four cases, two were arising from the celiac trunk, one from the left gastric artery and one from the right renal artery. CONCLUSION: The IPA usually originates from the aorta or celiac artery, and less frequently from the renal, hepatic or left gastric arteries. The IPA is a major source of collateral or parasitized arterial supply to hepatocellular carcinoma, second only to the hepatic artery. Literature on the IPA origin and clinical implications of variation in its origin have been reviewed in this article.

scholarly journals Rare Anatomic Variation: The Hepatosplenomesentericophrenic Trunk

Medicina ◽  
2021 ◽  
Vol 57 (2) ◽  
pp. 170
Author(s):  
Bogdan Gheorghe Hogea ◽  
Mugurel Constantin Rusu ◽  
Adelina Maria Jianu ◽  
Bogdan Adrian Manta ◽  
Adrian Cosmin Ilie
Keyword(s):  
Anatomic Variation ◽  
Celiac Trunk ◽  
Left Gastric Artery ◽  
Gastric Artery ◽  
Inferior Phrenic Artery ◽  
Phrenic Artery ◽  
Anatomic Variants ◽  
The Right ◽  
Rare Anatomic Variant ◽  
Anatomic Feature

The rare anatomic variants of the celiac trunk and superior mesenteric artery include the hepatosplenic, hepatosplenomesenteric (HSMT), celiacomesenteric, hepatomesenteric and gastrosplenic trunks. We report a 72-year-old female patient whose computed tomography angiograms indicated a rare anatomic feature whereby the right inferior phrenic artery was inserted in the origin of an HSMT, thus modifying it into a hepatosplenomesentericophrenic trunk (HSMPT). Above the HSMPT, the insertion of the left inferior phrenic artery in the origin of the left gastric artery determined a left gastrophrenic trunk (GPT). Proper identification of this type of rare anatomic variant is of utmost importance prior to different surgical procedures. For example, an HSMT origin of the right inferior phrenic artery is surgically relevant if this artery is an extrinsic pedicle of a hepatocellular carcinoma and is used for embolization of the tumor.

Transcatheter Chemoembolization of a Hepatocellular Carcinoma Utilizing Lipiodol through the Pancreaticoduodenal Arcade: A Case Report

2018 ◽  
Vol 2 ◽  
pp. 5
Author(s):  
Scott P Patterson ◽  
Richard G Foster
Keyword(s):  
Hepatocellular Carcinoma ◽  
Case Report ◽  
Vascular Anatomy ◽  
Left Gastric Artery ◽  
Target Lesion ◽  
Celiac Artery ◽  
Small Hepatocellular Carcinoma ◽  
Gastric Artery ◽  
Variant Anatomy ◽  
Pancreaticoduodenal Arcade

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.

scholarly journals Course and branch of the celiac artery in the red falcon (Buteo rufinus)

2010 ◽  
Vol 55 (No. 2) ◽  
pp. 79-86 ◽  
Author(s):  
A. Haligur ◽  
A. Duzler
Keyword(s):  
Left Gastric Artery ◽  
Celiac Artery ◽  
Gastroduodenal Artery ◽  
Terminal Branch ◽  
Gastric Artery ◽  
Pancreaticoduodenal Artery ◽  
Left Branch ◽  
Left And Right ◽  
The Right ◽  
Esophageal Artery

The present study was aimed at determining the origin, course and distribution of the celiac artery in eight adult red falcons, using a latex injection and dissection method. The celiac artery was ascertained to originate from the aorta at the level of the last 2–3 costae. The celiac artery was determined to split into two main branches, namely, left branch of the celiac artery and right branch of the celiac artery, in between the proventriculus and gizzard, and in the proximity of the lien. Prior to the indicated bifurcation, the celiac artery was observed to give off an esophageal artery and superior proventricular artery. In seven of the red falcons examined, splenic arteries, varying from two to four in number, were determined to spring from the celiac artery. Both the left and right hepatic arteries were ascertained to stem from the left branch of the celiac artery. The terminal branch of the left branch of the celiac artery, namely, the left gastric artery, was determined to have a fan-like distribution to the left surface of the gaster. The artery of the gall bladder was demonstrated to emanate from the left branch of the celiac artery in all of the red falcons examined, excluding one. The right branch of the celiac artery was determined to ramify into its terminal branches, namely, the right inferior gastric artery, ileocecal artery, pancreaticoduodenal artery, duodenojejunal artery and gastroduodenal artery, in the proximity of the pylorus which constitutes the gastro-duodenal passage.

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