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Pavlov R, Belbl M, Křeček J, Palouš D, Adla T, Kachlík D, Whitley A. A morphological study of the inferior phrenic arteries on multidetector computed tomography and angiography. Ann Anat 2024; 254:152258. [PMID: 38490465 DOI: 10.1016/j.aanat.2024.152258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 02/19/2024] [Accepted: 03/11/2024] [Indexed: 03/17/2024]
Abstract
INTRODUCTION The inferior phrenic artery is a paired artery with a variable origin and course, primarily supplying the diaphragm, but also the suprarenal glands, inferior vena cava, stomach, and oesophagus. The aim of this study is to investigate the origin and course of the inferior phrenic arteries on multidetector computed tomography and angiography. MATERIALS AND METHODS The anatomy of the inferior phrenic artery was analysed on 2449 multidetector computed tomography scans. Three-dimensional reconstructions were made of the main variations. Additionally, the course and branching pattern of the inferior phrenic artery were descriptively analysed in a cohort of 28 angiograms. RESULTS In 565 (23.1%) cases the inferior phrenic arteries arose as a common trunk and in 1884 (76.9%) cases as individual vessels. The most common origins of a common trunk were the coeliac trunk (n=303; 53.6%) and abdominal aorta (n=255; 45.1%). The most common origins of the right inferior phrenic artery were the coeliac trunk (n=965; 51.2%), abdominal aorta (n=562; 29.8%) and renal arteries (n=214; 11.4%). The most common origins of the left inferior phrenic artery were the coeliac trunk (n=1293; 68.6%) and abdominal aorta (n=403; 21.4%). CONCLUSION The inferior phrenic artery has a very variable anatomy. The most common origins of the inferior phrenic artery are the coeliac trunk and its branches, the abdominal aorta, and the renal arteries.
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Affiliation(s)
- Roman Pavlov
- Department of Anatomy, Second Faculty of Medicine, Charles University, V Úvalu 84, Praha 5 150 06, Czech Republic; Center for Endoscopic, Surgical and Clinical Anatomy (CESKA), Second Faculty of Medicine, Charles University, V Úvalu 84, Praha 5 150 06, Czech Republic
| | - Miroslav Belbl
- Department of Anatomy, Second Faculty of Medicine, Charles University, V Úvalu 84, Praha 5 150 06, Czech Republic; Center for Endoscopic, Surgical and Clinical Anatomy (CESKA), Second Faculty of Medicine, Charles University, V Úvalu 84, Praha 5 150 06, Czech Republic
| | - Jan Křeček
- Center for Endoscopic, Surgical and Clinical Anatomy (CESKA), Second Faculty of Medicine, Charles University, V Úvalu 84, Praha 5 150 06, Czech Republic; Cardiocenter, Third Faculty of Medicine, Charles University, Ruská 87, Praha 10 100 00, Czech Republic
| | - Daniel Palouš
- Department of Radiodiagnostic and Interventional Radiology, Institute for Clinical and Experimental Medicine, Vídeňská 1958, Praha 4 140 21, Czech Republic
| | - Theodor Adla
- Center for Endoscopic, Surgical and Clinical Anatomy (CESKA), Second Faculty of Medicine, Charles University, V Úvalu 84, Praha 5 150 06, Czech Republic; Department of Radiodiagnostic and Interventional Radiology, Institute for Clinical and Experimental Medicine, Vídeňská 1958, Praha 4 140 21, Czech Republic
| | - David Kachlík
- Department of Anatomy, Second Faculty of Medicine, Charles University, V Úvalu 84, Praha 5 150 06, Czech Republic; Center for Endoscopic, Surgical and Clinical Anatomy (CESKA), Second Faculty of Medicine, Charles University, V Úvalu 84, Praha 5 150 06, Czech Republic.
| | - Adam Whitley
- Department of Anatomy, Second Faculty of Medicine, Charles University, V Úvalu 84, Praha 5 150 06, Czech Republic; Center for Endoscopic, Surgical and Clinical Anatomy (CESKA), Second Faculty of Medicine, Charles University, V Úvalu 84, Praha 5 150 06, Czech Republic; Department of General Surgery, Third Faculty of Medicine, Charles University and University Hospital Královské Vinohrady, Šrobárova 50, Praha 10 100 00, Czech Republic
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Kim HC, Miyayama S, Choi JW, Kim GM, Chung JW. Hepatocellular Carcinoma Supplied by the Inferior Phrenic Artery or Cystic Artery: Anatomic and Technical Considerations. Radiographics 2022; 43:e220076. [DOI: 10.1148/rg.220076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Hyo-Cheol Kim
- From the Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, #101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea (H.C.K., J.W. Choi, J.W. Chung); Department of Diagnostic Radiology, Fukuiken Saiseikai Hospital, Fukui, Japan (S.M.); and Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea (G.M.K.)
| | - Shiro Miyayama
- From the Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, #101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea (H.C.K., J.W. Choi, J.W. Chung); Department of Diagnostic Radiology, Fukuiken Saiseikai Hospital, Fukui, Japan (S.M.); and Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea (G.M.K.)
| | - Jin Woo Choi
- From the Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, #101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea (H.C.K., J.W. Choi, J.W. Chung); Department of Diagnostic Radiology, Fukuiken Saiseikai Hospital, Fukui, Japan (S.M.); and Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea (G.M.K.)
| | - Gyoung Min Kim
- From the Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, #101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea (H.C.K., J.W. Choi, J.W. Chung); Department of Diagnostic Radiology, Fukuiken Saiseikai Hospital, Fukui, Japan (S.M.); and Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea (G.M.K.)
| | - Jin Wook Chung
- From the Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, #101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea (H.C.K., J.W. Choi, J.W. Chung); Department of Diagnostic Radiology, Fukuiken Saiseikai Hospital, Fukui, Japan (S.M.); and Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea (G.M.K.)
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Sawamura H, Onishi Y, Ohno T, Ikeda T, Yamamoto S, Seno H, Nakamoto Y. Selection of the right inferior phrenic artery using a dual-lumen microcatheter in transarterial chemoembolization for hepatocellular carcinoma. Radiol Case Rep 2022; 17:3727-3730. [PMID: 35965934 PMCID: PMC9363968 DOI: 10.1016/j.radcr.2022.07.077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 07/17/2022] [Indexed: 11/29/2022] Open
Abstract
An 88-year-old woman with a history of multiple hepatocellular carcinomas (HCCs) presented with a new HCC in segment seven of the liver. We decided to perform transarterial chemoembolization for HCC. During treatment, the HCC was supplied by the right inferior phrenic artery (IPA), which originated from the proximal part of the left gastric artery with a steep bifurcation angle. Due to the very short distance between the origins of the left gastric artery and right IPA, the microguidewire and microcatheter were unstable in the left gastric artery and easily prolapsed into the celiac artery. Although different types of microcatheters were used, the right IPA could not be selected. Therefore, we used a dual-lumen microcatheter (DLM) to select the right IPA. The DLM stabilized the microguidewire in the left gastric artery, and the right IPA was successfully selected. Subsequently, transarterial chemoembolization was administered using a branch of the right IPA. Given this experience, we will consider using a DLM as an alternative method for selecting an abdominal artery when other techniques are unsuccessful.
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Affiliation(s)
- Hirokazu Sawamura
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin-kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan
| | - Yasuyuki Onishi
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin-kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan
- Corresponding author.
| | - Tsuyoshi Ohno
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin-kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan
| | - Tomoya Ikeda
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, 54 Shogoin-kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan
| | - Shuji Yamamoto
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, 54 Shogoin-kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan
| | - Hiroshi Seno
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, 54 Shogoin-kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan
| | - Yuji Nakamoto
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin-kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan
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Liu X, Liao G, Luo X, Song W, Zhang H, Chen H, Cai S, Guo D. Hepatocellular Carcinoma With Different Areas of Right Retroperitoneal Space Invasion: Evaluation of Transcatheter Arterial Chemoembolization Efficacy and Blood Supply Characteristics. Front Oncol 2020; 10:539692. [PMID: 33072569 PMCID: PMC7538699 DOI: 10.3389/fonc.2020.539692] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 08/25/2020] [Indexed: 12/31/2022] Open
Abstract
Purpose To evaluate the therapeutic efficacy of transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) with different areas of right retroperitoneal space (rRPS) invasion and analyze the blood supply. Methods This retrospective study enrolled 41 patients with HCC with different areas of rRPS invasion treated with TACE, including 22 HCCs with superior aspect of the right perirenal space (SARPS) invasion and 19 HCCs with right anterior pararenal space (RAPS) invasion. The overall response rate (ORR) and disease control rate (DCR) were analyzed. The prognostic factors for overall survival (OS) after TACE were determined. The blood supply characteristics of HCC with different areas of rRPS invasion were analyzed with arteriograms. Results All patients underwent 2.8 ± 1.8 TACE sessions over 25.0 ± 21.9 months. The median OS was 29.0 months for patients with SARPS invasion and 12.0 months for patients with RAPS invasion (P = 0.004). Only the invaded area of the rRPS was an independent prognostic factor for OS [hazard ratio (HR), 2.833; 95% CI, 1.297–6.188; and P = 0.009). The ORR and DCR were significantly higher in the group with SARPS invasion than in the group with RAPS invasion (ORR: 63.6% vs 31.6%, P = 0.041; DCR: 77.3% vs 47.4%, P = 0.047). Initially, HCC with SARPS invasion were supplied by the hepatic artery (HA; n = 8) and both the HA and extrahepatic collateral vessels (EHCs; n = 14); HCC with RAPS invasion were supplied by the HA (n = 10) and both the HA and EHCs (n = 9); as the TACE sessions increased, the tumor-feeding vessels shifted from the HA to both the HA and EHCs, and even EHCs could be the only blood supply. Rare EHCs appeared earlier and more frequently in the RAPS group than in the SARPS group. Conclusion The efficacy of TACE differed for HCC with different areas of rRPS invasion, and the median OS, ORR and DCR were significantly better in the SARPS group than in the RAPS group. Different common EHCs supplied HCCs with different areas of rRPS invasion, while other rare EHCs appeared more frequently in the RAPS group.
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Affiliation(s)
- Xi Liu
- Department of Radiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Guangsheng Liao
- Department of Radiology, Chongqing Traditional Chinese Medicine Hospital, Chongqing, China
| | - Xiaoping Luo
- Department of Radiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Wenlong Song
- Department of Radiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Haiping Zhang
- Department of Radiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hao Chen
- Department of Radiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Shangzhi Cai
- Department of Radiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Dajing Guo
- Department of Radiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Blood supply to the caudate lobe of the liver from the right inferior phrenic artery: observation by cone-beam computed tomography during arteriography. Abdom Radiol (NY) 2020; 45:2851-2861. [PMID: 32219476 DOI: 10.1007/s00261-020-02489-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
PURPOSE To retrospectively evaluate blood supply to the caudate lobe of the liver from the right inferior phrenic artery (RIPA) using cone-beam computed tomography during arteriography (CBCTA-RIPA). METHODS CBCTA-RIPA examinations during transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) were collected from 2448 procedures in 787 patients. The exclusion criteria were (1) major artifacts, (2) TACE of hepatic arterial branches before performing CBCTA-RIPA, and (3) repeated CBCTA-RIPA studies in the same patient. Blood supply to three subsegments, the Spiegel lobe (SP), paracaval, and caudate process, was evaluated on CBCTA-RIPA images. The origins and routes of branches supplying the caudate lobe were also evaluated by three-dimensional vessel-tracking software. RESULTS Forty-seven CBCTA-RIPA examinations in 47 patients (38 with a history of TACE [repeated TACE group] and nine without it [initial TACE group]) were eligible, including five who had previously undergone hepatectomy. Seven had caudate lobe HCCs. Blood supply to the caudate lobe was demonstrated in 21 (44.7%) patients: in 50% (19/38) and 22.2% (2/9) of the repeated and initial TACE groups, respectively. The caudate arteries had previously been embolized in eight patients, the RIPA branch in three, and both in one. Forty-one proximal branches mainly supplied the dorsal part of the SP. All branches but five reached there through the inferior vena cava (IVC) ligament. The RIPA supplied eight of nine caudate lobe HCCs, totally (n = 7) or partially (n = 1). CONCLUSION The proximal RIPA branches mainly supply the dorsal SP through the IVC ligament, especially in the repeated TACE group.
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Wattanasatesiri T, Chung JW, Choi TW, Kim HC, Lee M, Hur S. Shaping the tip of microcatheters for superselective catheterization: steam vs. manual methods. Diagn Interv Radiol 2020; 26:456-463. [PMID: 32673203 DOI: 10.5152/dir.2020.19314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
PURPOSE We aimed to evaluate and compare the shapeability and stability of five microcatheters commonly used in interventional radiology after steam shaping and manual shaping. METHODS Steam shaping was performed using three mandrels of different angles: L(S) shape (90°), U(S) shape (180°), and O(S) shape (360°). Three manual shapes-L(M), U(M), and O(M)-were made to have a similar angle to their steam-shaped counterparts. The stability of the microcatheters was evaluated by passing them through a 5 F catheter and inserting microguidewires. The tip angles of the microcatheters and the angle change rates were compared between groups. RESULTS The mean angle of the microcatheters after steam shaping was 42.4°-54.1° for L(S) shape, 80.2°-96.7° for U(S) shape, and 130.7°-150.8° for O(S) shape. Five microcatheters showed significantly different mean angle reductions after passing through the 5 F catheter (17.4%-30.3%) and inserting microguidewires (24.1%-61.2%). Different microguidewires also caused significantly different mean angle reductions (34.6%-50.8%). The reduced angle caused by the guidewire was almost completely recovered after withdrawing it (93.2%-101.6%). Although manual-shaped microcatheters showed a 4.2%-6.3% greater angle reduction than steam-shaped microcatheters after passing through the 5 F catheter, the final tip angle was not significantly different between the two groups and was within 10%. CONCLUSION The tip angle of the microcatheters after steam shaping using mandrels may differ depending on the shape of the mandrel and the type of microcatheter used, and the stability varies depending on the type of microcatheter. The manual shaping of microcatheters can be a good alternative to steam shaping.
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Affiliation(s)
| | - Jin Wook Chung
- Department of Radiology, Seoul National University Hospital, Seoul, South Korea
| | - Tae Won Choi
- Department of Radiology, Seoul National University Hospital, Seoul, South Korea
| | - Hyo-Cheol Kim
- Department of Radiology, Seoul National University Hospital, Seoul, South Korea
| | - Myungsu Lee
- Department of Radiology, Seoul National University Hospital, Seoul, South Korea
| | - Saebeom Hur
- Department of Radiology, Seoul National University Hospital, Seoul, South Korea
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Yoshida K, Matsui O, Miyayama S, Ibukuro K, Yoneda N, Inoue D, Kozaka K, Minami T, Koda W, Gabata T. Isolated Arteries Originating from the Intrahepatic Arteries: Anatomy, Function, and Importance in Intervention. J Vasc Interv Radiol 2018; 29:531-537.e1. [PMID: 29477620 DOI: 10.1016/j.jvir.2017.12.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 12/02/2017] [Accepted: 12/05/2017] [Indexed: 02/07/2023] Open
Abstract
Isolated hepatic arteries are defined as hepatic terminal arterioles that are not accompanied by portal venules or bile ductules and penetrate the liver parenchyma and distribute to the hepatic capsule and intrahepatic hepatic veins. Abundant communications exist between intra- and extrahepatic arteries through isolated arteries and capsular arterial plexus. They play a principal role in the development of subcapsular hemorrhage and arterial collateral formation following transcatheter arterial chemoembolization for liver cancers. The anatomy, function, and clinical importance of isolated hepatic arteries in interventional radiology, especially regarding subcapsular hemorrhage and arterial collateral formation, are highlighted in this article.
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Affiliation(s)
- Kotaro Yoshida
- Department of Radiology, Kanazawa University School of Medical Sciences, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan.
| | - Osamu Matsui
- Department of Radiology, Kanazawa University School of Medical Sciences, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Shiro Miyayama
- Department of Diagnostic Radiology, Fukui-ken Saiseikai Hospital, Fukui City, Fukui, Japan
| | - Kenji Ibukuro
- Department of Radiology, Mitsui Memorial Hospital, Tokyo, Japan
| | - Norihide Yoneda
- Department of Radiology, Kanazawa University School of Medical Sciences, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Dai Inoue
- Department of Radiology, Kanazawa University School of Medical Sciences, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Kazuto Kozaka
- Department of Radiology, Kanazawa University School of Medical Sciences, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Tetsuya Minami
- Department of Radiology, Kanazawa University School of Medical Sciences, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Wataru Koda
- Department of Radiology, Kanazawa University School of Medical Sciences, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Toshifumi Gabata
- Department of Radiology, Kanazawa University School of Medical Sciences, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
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Lokken RP, Fidelman N, Kolli KP, Kerlan RK. Safety and Efficacy of Doxorubicin Drug-Eluting Embolic Chemoembolization of Hepatocellular Carcinoma Supplied by Extrahepatic Collateral Arteries. J Vasc Interv Radiol 2016; 27:1698-1704. [DOI: 10.1016/j.jvir.2016.04.034] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Revised: 04/26/2016] [Accepted: 04/28/2016] [Indexed: 11/25/2022] Open
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Incidence and therapeutic frequency of extrahepatic collateral arteries in transcatheter arterial chemoembolization of hepatocellular carcinoma: Experience from 182 patients with survival time more than 3 years. Eur J Radiol 2015; 84:2555-63. [PMID: 26481483 DOI: 10.1016/j.ejrad.2015.10.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Revised: 08/08/2015] [Accepted: 10/02/2015] [Indexed: 11/21/2022]
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Evaluation of extrahepatic collateral arteries in hepatocellular carcinoma in three independent groups in a single center. Exp Ther Med 2015; 10:2366-2374. [PMID: 26668643 DOI: 10.3892/etm.2015.2822] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Accepted: 06/18/2015] [Indexed: 01/10/2023] Open
Abstract
To improve the efficacy of transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC), this study evaluated the prevalence and causes of extrahepatic arteries (EHAs) and identified feeding arteries in HCCs in three independent clinical groups in a single inverventional radiology center. Between November 2011 and September 2012, 942 cases of HCC were included in this retrospective study. The patients were treated in three independent groups of 285, 301 and 356 patients, respectively. Enhanced computed tomography, enhanced magnetic resonance imaging and digital subtraction angiography were reviewed retrospectively and correlations between the presence of tumor-feeding EHAs and tumor number, size and location in the liver, number of repeat TACE procedures and complications were assessed. There were 698 EHAs in the 942 cases of HCC, with 182, 233 and 283 EHAs in the three independent groups, respectively. Tumor size was associated with EHA formation; the percentages of patients with EHAs were 2.7±3.0, 5.5±0.5, 43.2±4.0, 61.8±5.2 and 93.4±1.8% with tumor sizes of 2-3, 3-5, 5-7, 7-9 and >9 cm, respectively. There were 159±19 EHAs in each group feeding tumors in peripheral locations in the liver, but only 48.7±6.8 in the central zone. The most common EHA was the right inferior phrenic artery, with a mean of 101.0±14.1 per group. The number of EHAs increased proportionally with the number of TACE sessions. The number of EHAs was positively associated with tumor size, peripheral location of the tumor and number of TACE sessions.
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Yan J, Nagasawa Y, Nakano M, Hitomi J. Origin of the celiac and superior mesenteric arteries in a common trunk: description of a rare vessel variation of the celiacomesenteric trunk with a literature review. Okajimas Folia Anat Jpn 2015; 91:45-8. [PMID: 25492844 DOI: 10.2535/ofaj.91.45] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
A variation artery was observed in a Japanese cadaver. The celiac and superior mesenteric arteries arose from a common trunk (also referred to as the celiacomesenteric trunk), but not from the abdominal aorta, respectively. From the common trunk, the common hepatic artery was distributed in the right part of the liver, and the left hepatic artery arose from the left gastric artery, which also arose from the common trunk. The left inferior phrenic artery arose from the common trunk, but the right inferior phrenic artery arose from the right middle suprarenal artery. This information regarding the branch pattern in this variation artery is useful for clinical examination and treatment.
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Affiliation(s)
- Jun Yan
- Department of Anatomy, School of Medicine, Iwate Medical University
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Gürses İA, Gayretli Ö, Kale A, Öztürk A, Usta A, Şahinoğlu K. Inferior Phrenic Arteries and Their Branches, Their Anatomy and Possible Clinical Importance: An Experimental Cadaver Study. Balkan Med J 2015; 32:189-95. [PMID: 26167344 DOI: 10.5152/balkanmedj.2015.150052] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Accepted: 12/11/2014] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Transcatheter arterial chemoembolization is a common treatment for patients with inoperable hepatocellular carcinoma. If the carcinoma is advanced or the main arterial supply, the hepatic artery, is occluded, extrahepatic collateral arteries may develop. Both, right and left inferior phrenic arteries (RIPA and LIPA) are the most frequent and important among these collaterals. However, the topographic anatomy of these arteries has not been described in detail in anatomy textbooks, atlases and most previous reports. AIMS To investigate the anatomy and branching patterns of RIPA and LIPA on cadavers and compare our results with the literature. STUDY DESIGN Descriptive study. METHODS We bilaterally dissected 24 male and 2 female cadavers aged between 49 and 88 years for this study. RESULTS The RIPA and LIPA originated as a common trunk in 5 cadavers. The RIPA originated from the abdominal aorta in 13 sides, the renal artery in 2 sides, the coeliac trunk in 1 side and the left gastric artery in 1 side. The LIPA originated from the abdominal aorta in 9 sides and the coeliac trunk in 6 sides. In 6 cadavers, the ascending and posterior branches of the LIPA had different sources of origin. CONCLUSION As both the RIPA and LIPA represent the half of all extrahepatic arterial collaterals to hepatocellular carcinomas, their anatomy gains importance not only for anatomists but interventional radiologists as well.
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Affiliation(s)
- İlke Ali Gürses
- Department of Anatomy, İstanbul University, İstanbul Faculty of Medicine, İstanbul, Turkey
| | - Özcan Gayretli
- Department of Anatomy, İstanbul University, İstanbul Faculty of Medicine, İstanbul, Turkey
| | - Ayşin Kale
- Department of Anatomy, İstanbul University, İstanbul Faculty of Medicine, İstanbul, Turkey
| | - Adnan Öztürk
- Department of Anatomy, İstanbul University, İstanbul Faculty of Medicine, İstanbul, Turkey
| | - Ahmet Usta
- Department of Anatomy, İstanbul University, İstanbul Faculty of Medicine, İstanbul, Turkey
| | - Kayıhan Şahinoğlu
- Department of Anatomy, İstanbul University, İstanbul Faculty of Medicine, İstanbul, Turkey
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Variant arterial supply to the lesser curvature of the stomach and duodenum from double inferior phrenic arteries. Surg Radiol Anat 2014; 37:867-9. [PMID: 25380829 DOI: 10.1007/s00276-014-1392-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Accepted: 11/03/2014] [Indexed: 10/24/2022]
Abstract
A rare case of the left accessory inferior phrenic artery (IPA) supplying the lesser curvature of the stomach and the right accessory IPA supplying the duodenum was observed during interventional radiography. To our knowledge, variation arteries supplying the stomach and duodenum have never been reported in English literature; herein, we report the first case of variant arterial supply to the lesser curvature of the stomach and duodenum from double IPAs.
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Koganemaru M, Abe T, Anai H, Tanaka N, Nonoshita M, Iwamoto R, Kusumoto M, Kuhara A, Kugiyama T, Hayabuchi N. A newly developed double lumen microballoon catheter with a side hole: initial experience of intraarterial infusion chemotherapy and/or embolization. Jpn J Radiol 2012; 30:870-4. [DOI: 10.1007/s11604-012-0128-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2012] [Accepted: 08/23/2012] [Indexed: 12/28/2022]
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Arterial blood supply to the caudate lobe of the liver from the proximal branches of the right inferior phrenic artery in patients with recurrent hepatocellular carcinoma after chemoembolization. Jpn J Radiol 2011; 30:45-52. [PMID: 22139759 DOI: 10.1007/s11604-011-0007-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2011] [Accepted: 07/31/2011] [Indexed: 02/07/2023]
Abstract
PURPOSE To evaluate the arterial blood supply to the caudate lobe of the liver from the proximal branches of the right inferior phrenic artery (RIPA) in patients with recurrent hepatocellular carcinoma after transcatheter arterial chemoembolization (TACE). MATERIALS AND METHODS Thirteen patients, including 10 who had a history of TACE of the caudate artery (A1), underwent TACE of the proximal RIPA branches. Iodized oil distribution was evaluated by computed tomography (CT) 1-week after TACE. Angiographic findings were also evaluated. RESULTS Previously embolized A1 was occluded (n = 15) or attenuated (n = 2). In one of three patients without A1 TACE, A1 was also attenuated. TACE was performed at the first branch of the proximal RIPA (n = 8), the first branch of the anterior branch (n = 6), and the first branch of the posterior branch (n = 1), respectively. Iodized oil was mainly distributed into the dorsal part of the Siegel lobe (SP) (n = 10), the caudate process (n = 1), and both (n = 2). In three of seven patients who had undergone serial RIPA angiography, RIPA parasitization to SP was suspected before A1 TACE. CONCLUSION The proximal RIPA branches mainly supply the SP when A1 is attenuated.
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