Celiac artery

Invasion into peripancreatic arteries celiac trunk, hepatic artery, superior mesenteric artery (T4)... 

It also appears that the incidence of hepatic adenomas is increased in women taking oral contraceptives. Ischemic bowel disease secondary to thrombosis of the celiac and superior and inferior mesenteric arteries and veins has also been reported in women using these drugs. 

The visceral vessels are evaluated for patency because the required coverage of the inferior mesenteric artery mandates that blood supply to the viscera be adequate from other sources (celiac and superior mesenteric arteries). With experience, some of these contraindications can be overcome with suprarenal attachment devices, additional cuffs, and limbs, but for the nascent EVAR physician the contraindications should be acknowledged and adherence to the fundamental principles of endovascular device implantation will permit good outcomes. 

Deeg KH, Rupprecht T, Schmid E (1993) Doppler sonographic detection of increased flow velocities in the celiac trunk and superior mesenteric artery in infants with necrotizing enterocolitis. Pediatr Radiol 23 578-582 del Pozo G (2005) Intussusception still work in progress. Pediatr Radiol 35 92-94... 

Since TXA2 is an extremely unstable, highly potent compound, immediate bioassay is the only possible method for the assay of the intact compound. The most commonly employed assay organs are various vascular preparations, such as the rabbit aorta, mesenteric artery or celiac artery [15,19,20,29,30,108]. Other possibili-... 

In the classical description of the arterial anatomy, the celiac trunk trifurcates into the left gastric, splenic, and common hepatic arteries. The common... 

Quite often the hepatic artery has an incomplete set of branches because one or the other of its usual branches arises from a source other than the proper hepatic artery from the celiac trunk. Such a vessel if from an outside source is spoken of as aberrant ... 

An aberrant hepatic artery refers to a branch that does not arise from its usual source (i.e. proper hepatic artery from the celiac trunk). This type of artery may be a substitute for the usual hepatic artery that is absent, in which case it is referred to as an aberrant replaced hepatic artery. In other cases there may be an additional artery to the one normally present hence the term aberrant accessory artery. 

Fig. 4.4. A rare anatomical variant consisting in the origin of the right hepatic artery (arrow) from the celiac trunk...

CHA, common hepatic artery LHA, left hepatic artery LGA, left gastric artery RHA, right hepatic artery SMA, superior mesenteric artery GDA, gastroduodenal artery CT, celiac trunk... 

The dorsal pancreatic artery is the first major pancreatic branch, usually coming off the splenic artery, although many variations have been described (right hepatic artery, SMA, and celiac artery) [15]. After supplying the dorsal surface of the neck of the pancreas, it divides into a left branch, the transverse pancreatic, and into a right branch (branches), which unites with the gastroduodenal or the superior pancreatoduodenal [14]. 

Fig. 4. 7a,b. Patient with a stenosis of the celiac trunk, a Superior mesenteric angiography demonstrates reversed flow through the pancreatoduodenal arcade (arrow) with opacification of the hepatic artery (arrowhead), b Tumour was treated after selective catheterization of the right hepatic artery through the collateral network... 

Michels NA (1953) Collateral arterial pathways to the liver after ligation of the hepatic artery and removal of the celiac axis. Cancer 6 708-724... 

Michels NA (1951) The hepatic, cystic and retroduode-nal arteries and their relations to the biliary ducts with samples of the entire celiacal blood supply. Ann Surg 133 503-524... 

Fig. 5.5. a Celiac arteriogram demonstrates patent gastroduodenal artery (GDA) (black arrows) andright gastric (arrowheads). b GDA has been embolized (black arrows). Flow noted in right gastric artery (RGA) (white arrowheads), c Catheterization of the RGA (white arrows), d Both GDA (black arrows) and RGA (white arrow) embolized... 

Bowersox JC, Zwolak RM, Walsh DB et al (1991) Duplex ultrasonography in the diagnosis of celiac and mesenteric artery occlusive disease. J Vase Surg 14 780-788... 

Aliotta A, Pompili M, Rapaccini GL et al (1997) Doppler ultrasonographic evaluation of blood flow in the superior mesenteric artery in celiac patients and in healthy controls in fasting conditions and after saccharose. J Ultrasound Med... 

Fig. 5.1. DSA of celiac trunk with a 5-F Cobra catheter. Left gastric artery (white arrow), splenic artery (arrowheads), common hepatic artery (white arrowhead), gastroduodenal artery (small white arrow), right gastroepiploic artery (small white arrowheads), left (small arrow) and right (double small arrow) hepatic artery...

The gastrointestinal tract is supplied by the unpaired visceral arteries branching from the abdominal aorta the celiac trunk (Fig. 5.1), superior and inferior mesenteric artery. 

In stable and cooperative patients, the diagnostic arteriography is performed under local anesthesia via a transfemoral access and in the classical Seldinger technique. Celiac trunk and the superior mesenteric artery (SMA) are catheterized with preshaped single-use 4- or 5-F catheters of the Cobra or side-winder type. lodinated nonionic iso-osmolar contrast medium (25-35 ml at a rate of 4-6 ml/s) is injected by a power injector into the celiac trunk and SMA. In patients with renal insufficiency, contrast allergy or hyperthyroidism gadolinium chelates (MRI contrast medium) have been suggested as a substitute for iodinated contrast medium [53], but reports on its use in the visceral arteries are still awaited. 

The arteriograms of the celiac trunk and superior mesenteric artery should completely map the gastroduodenal blood supply. Anatomical variants should be searched for (esophageal, phrenic, hepatic arteries branching from the aorta, direct origin of the left gastric from the aorta, etc.). If all territories are visualized and no bleeding source... 

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