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

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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Replacement of the common hepatic artery by the left gastric artery: A rare variant in gastric cancer surgery

European Journal of Surgical Oncology ◽

10.1016/j.ejso.2008.02.007 ◽

2008 ◽

Vol 34 (8) ◽

pp. 943-944

Author(s):

H. Yamashita ◽

F. Yoshimi ◽

K. Mori ◽

Y. Mochizuki ◽

H. Nagai ◽

...

Keyword(s):

Gastric Cancer ◽

Hepatic Artery ◽

Rare Variant ◽

Left Gastric Artery ◽

Common Hepatic Artery ◽

Cancer Surgery ◽

Gastric Artery ◽

Gastric Cancer Surgery ◽

The Common

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The common hepatic artery arising from the left gastric artery

Surgical and Radiologic Anatomy ◽

10.1007/s00276-010-0662-0 ◽

2010 ◽

Vol 32 (7) ◽

pp. 703-705 ◽

Cited By ~ 7

Author(s):

Yoshitaka Okada ◽

Naoko Nishi ◽

Yuka Matsuo ◽

Takeyuki Watadani ◽

Fumiko Kimura

Keyword(s):

Hepatic Artery ◽

Left Gastric Artery ◽

Common Hepatic Artery ◽

Gastric Artery ◽

The Common

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New method of hepatic artery reconstruction after its injury or resection.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e16221 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. e16221-e16221

Author(s):

Oksana V. Katelnitskaya ◽

Oleg I. Kit ◽

Yuriy A. Gevorkyan ◽

Aleksandr V. Snezhko ◽

Oleg Yu. Kaymakchi ◽

...

Keyword(s):

Blood Flow ◽

Hepatic Artery ◽

Left Gastric Artery ◽

Common Hepatic Artery ◽

Arterial Blood Flow ◽

Gastric Artery ◽

Arterial Blood ◽

Iatrogenic Damage ◽

The Common ◽

Reduced Time

e16221 Background: Restoration the hepatic arterial blood flow is required in traumatic or iatrogenic damage to the hepatic artery and its branches, as well as in the planned resection of the hepatic artery with subsequent reconstruction. Various ways have been proposed to solve this problem: ligation of the hepatic artery and its branches, which is associated with an extremely high mortality rate, reaching 70%, and the need for extensive liver resections; portal vein arteriolization; transposition of the splenic artery with its severe complications (heart attack, abscess) or hepatic artery replacement sometimes are not available and imply aggressive anticoagulant therapy, which is often challenging after extensive oncological interventions. Prosthetic vascular grafts are associated with a high risk of infection. We propose replacement of the common hepatic artery defect by transposition of the left gastric artery and end-to-end anastomosis between the proximal end of the left gastric artery and the distal end of the hepatic artery. Methods: The proposed method was applied in 7 cancer patients - 4 cases of iatrogenic damage to the common hepatic artery in lymph node dissection of the hepatoduodenal ligament and 3 resection of the common hepatic artery with tumor infiltration. The mean age of patients was 53 years. 2 patients had surgery for gastric cancer, 5 - pancreatic cancer. Results: The vascular reconstruction lasted for 17 minutes. No thrombotic complications of the reconstruction area or liver necrosis in the postoperative period were registered. The main advantages of this method were the absence of synthetic materials or deficit blood supply to neighboring organs, and no need for extensive mobilization of the great vessels in other areas (renal artery, abdominal aorta). Conclusions: The proposed method for reconstruction of the hepatic artery allows performing a simple and adequate restoration of the hepatic arterial blood flow, reduced time of the vascular stage of the surgery and reduced incidence of postoperative complications associated with the vascular stage - reduced time of liver ischemia and reduced risk of thrombosis in the reconstruction area.

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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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