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

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.

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

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

scholarly journals Endovascular retrieval of a dislocated pushable coil in the common hepatic artery using a cerebral stent retriever

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Mohammed Shamseldin ◽  
Albrecht Stier ◽  
Norbert Hosten ◽  
Ralf Puls
Keyword(s):  
Case Report ◽  
Hepatic Artery ◽  
Common Hepatic Artery ◽  
Stent Retriever ◽  
Arterial Blood Flow ◽  
Slowing Down ◽  
Arterial Blood ◽  
First Case ◽  
Stent Retrievers ◽  
The Common

Abstract Background This is case of removing a dislocated pushable coil from the common hepatic artery (CHA) as a possible complication of using pushable coils in the embolization of an upper gastrointestinal bleeding (UGIB) from the gastroduodenal artery (GDA) by using a pRESET stent retriever (Phenox, Bochum, Germany) which is utilized mainly for treatment of endovascular stroke. Case presentation An 88-year-old female patient was referred to our hospital to get an emergency embolization of the GDA causing an UGIB with a relevant drop of the hemoglobin level. During the routine embolization of the GDA using pushable coils, a complete dislocation of the last coil into the CHA took place leading to a relevant slowing down of the arterial blood flow to the liver. A decision was thereby made to remove the dislocated coil to avoid further possible complications which was successfully achieved. Conclusions Various stent retrievers have been proven to be effective in removing dislocated coils during intracerebral coiling of different pathologies. This case report is to our knowledge the first case report proving the high efficacy and safety of using yet another stent retriever, namely a pRESET stent retriever in removing a fully dislocated coil in the abdominal vessels, namely in this case the CHA.

The common hepatic artery arising from the left gastric artery

2010 ◽  
Vol 32 (7) ◽  
pp. 703-705 ◽  
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

scholarly journals Endovascular Retrieval of a Dislocated Pushable Coil in the Common Hepatic Artery Using a Cerebral Stent Retriever

2021 ◽  
Author(s):  
Mohammed Shamseldin
Keyword(s):  
Case Report ◽  
Hepatic Artery ◽  
Common Hepatic Artery ◽  
Stent Retriever ◽  
Arterial Blood Flow ◽  
Slowing Down ◽  
Arterial Blood ◽  
First Case ◽  
Stent Retrievers ◽  
The Common

Abstract BACKGROUNDThis is case of removing a dislocated pushable coil from the common hepatic artery (CHA) as a possible complication of using pushable coils in the embolization of an upper gastrointestinal bleeding (UGIB) from the gastroduodenal artery (GDA) by using a pRESET stent retriever (Phenox, Bochum, Germany) which is utilized mainly for treatment of endovascular stroke.CASE PRESENTATIONAn 88-year-old female patient was referred to our hospital to get an emergency embolization of the GDA causing an UGIB with a relevant drop of the hemoglobin level. During the routine embolization of the GDA using pushable coils, a complete dislocation of the last coil into the CHA took place leading to a relevant slowing down of the arterial blood flow to the liver. A decision was thereby made to remove the dislocated coil to avoid further possible complications which was successfully achieved. CONCLUSIONSVarious stent retrievers have been proven to be effective in removing dislocated coils during intracerebral coiling of different pathologies. This case report is to our knowledge the first case report proving the high efficacy and safety of using yet another stent retriever, namely a pRESET stent retriever in removing a fully dislocated coil in the abdominal vessels, namely in this case the CHA.

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

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.

scholarly journals Pancreatoduodenectomy with an anomalous common hepatic artery and the left gastric artery arising from a common trunk

2019 ◽  
Vol 2019 (3) ◽  
Author(s):  
Yuhei Waki ◽  
Ryo Ashida ◽  
Teiichi Sugiura ◽  
Yukiyasu Okamura ◽  
Takaaki Ito ◽  
...  
Keyword(s):  
Hepatic Artery ◽  
Left Gastric Artery ◽  
Common Hepatic Artery ◽  
Common Trunk ◽  
Gastric Artery

scholarly journals Computational Modeling of the Liver Arterial Blood Flow for Microsphere Therapy: Effect of Boundary Conditions

2020 ◽  
Vol 7 (3) ◽  
pp. 64
Author(s):  
Amirtahà Taebi ◽  
Rex M. Pillai ◽  
Bahman S. Roudsari ◽  
Catherine T. Vu ◽  
Emilie Roncali
Keyword(s):  
Blood Flow ◽  
Boundary Conditions ◽  
Hepatic Artery ◽  
Transarterial Embolization ◽  
Arterial Blood Flow ◽  
Patient Specific ◽  
Computational Domain ◽  
Arterial Tree ◽  
Arterial Blood ◽  
Therapy Effect

Transarterial embolization is a minimally invasive treatment for advanced liver cancer using microspheres loaded with a chemotherapeutic drug or radioactive yttrium-90 (90Y) that are injected into the hepatic arterial tree through a catheter. For personalized treatment, the microsphere distribution in the liver should be optimized through the injection volume and location. Computational fluid dynamics (CFD) simulations of the blood flow in the hepatic artery can help estimate this distribution if carefully parameterized. An important aspect is the choice of the boundary conditions imposed at the inlet and outlets of the computational domain. In this study, the effect of boundary conditions on the hepatic arterial tree hemodynamics was investigated. The outlet boundary conditions were modeled with three-element Windkessel circuits, representative of the downstream vasculature resistance. Results demonstrated that the downstream vasculature resistance affected the hepatic artery hemodynamics such as the velocity field, the pressure field and the blood flow streamline trajectories. Moreover, the number of microspheres received by the tumor significantly changed (more than 10% of the total injected microspheres) with downstream resistance variations. These findings suggest that patient-specific boundary conditions should be used in order to achieve a more accurate drug distribution estimation with CFD in transarterial embolization treatment planning.

Participation of adrenoceptors in liver blood flow regulation in anesthetized dogs

1987 ◽  
Vol 253 (5) ◽  
pp. H1053-H1058
Author(s):  
N. Terada ◽  
S. Koyama ◽  
J. Horiuchi ◽  
T. Takeuchi
Keyword(s):  
Blood Flow ◽  
Portal Vein ◽  
Hepatic Artery ◽  
Vascular Resistance ◽  
Adrenergic Receptors ◽  
Liver Blood Flow ◽  
Arterial Blood Flow ◽  
Tissue Blood Flow ◽  
Intact Group ◽  
Arterial Blood

We evaluated involvement of adrenergic receptors in the responses of the hepatic vasculature to reduction either of portal venous flow or hepatic arterial inflow. Portal vein occlusion caused an increase in hepatic arterial blood flow (HAF) and decreases in hepatic arterial pressure (HAP) and hepatic arterial vascular resistance (HAR) in the intact group. After pretreatment with either yohimbine or prazosin, but not propranolol, occlusion of the portal vein produced a greater decrease in HAP as compared with that in the intact group. No significant changes in HAF, HAR, or hepatic tissue blood flow (HTF) occurred after the treatment. These results indicate that the compensatory response of the hepatic arterial vasculature to altered portal blood flow (PVF) is regulated independently of the intrahepatic adrenergic receptors. Hepatic arterial occlusion caused a significant decrease in portal venous pressure, PVF, and HTF. Portal venous vascular resistance (PVR) was reduced slightly, but not significantly. After pretreatment with either yohimbine or prazosin, but not propranolol, occlusion of the hepatic artery produced an opposite effect: to increase PVF and significantly decrease PVR. These results indicate that intrahepatic alpha-adrenoceptors participate in the regulation of portal vascular tone to maintain portal vein pressure at a steady level, when inflow from the hepatic artery is reduced.

Sign in / Sign up

Export Citation Format

Share Document