Artery common hepatic

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

Fig. 4.1. CT angiogram showing an independent origin from the abdominal aorta of the common hepatic artery, the left gastric artery, and the splenic artery. This information is useful prior to performing a DSA study...

LHA, left hepatic artery RHA, right hepatic artery LGA, left gastric artery SMA, superior mesenteric artery CHA, common hepatic artery... 

The typical origin of this vessel is the right hepatic artery in as many as 95% of patients [25], but it may also come up from the left hepatic artery (7%), common hepatic artery (3%), replaced or accessory right hepatic arteries (18%), as well as the gastroduodenal artery (1%) or superior mesenteric artery [26-29]. There is a 2%-15% incidence of double cystic artery [26, 30] (Fig. 4.12). 

Common hepatic artery (CHA) - Injection rate of 3 cc/s for 12 cc. This injection rate allows for the flooding of the hepatic circulation, optimizing the likelihood that extrahepatic vessels will be identified. Vessels of note that may require embolization arising off the common hepatic in-... 

Fig. 5.2. White arrow points to superior mesenteric artery, black arrow to the replaced common hepatic artery...

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...

Fig. 5.8a-d. A 79-year-old male, who underwent a left nephrectomy for renal cell cancer 1 year previously, now presents with melena from bleeding duodenal metastases. a DSA of the common hepatic artery showing hypervascular tumor blush (arrows) in the duodenum, supplied by hypertrophied duodenal branches of the gastroduodenal artery. b,c Superselective visualization of two different tumor compartments (arrows) with a 2.7-F microcatheter (arrowheads), d Control DSA after injection of several millilitres of PVA 150-250 p and 250-355 p in four tumor feeders (two of them shown here), confirming tumor devascularization. After each injection of 0.5-1 ml of PVA, superselective DSA was performed to control flow arrest and prevent reflux of particulates. Patient stopped bleeding for about 7 months and was then retreated... 

Fig. 3.2. Axial image (left) shows hypo-vascular pancreatic cancer (arrow) in continuity with peripancreatic artery (arrowhead). Volume rendered angiogram from same data set shows the vessel is a replaced common hepatic artery arising from the superior mesenteric artery (arrow)...

Fig. 20.3a,b. Hepatic arterial anatomy according to Hiatt. aMIP reconstruction of Hiatt s type 1 anatomy i.e., conventional anatomy with the common hepatic artery arising from the celiac axis to the gastroduodenal and proper hepatic arteries. The proper hepatic artery divides distally into right and left branches, b MIP reconstruction of Hiatt s type 3 anatomy i.e., a replaced right hepatic artery originating from the superior mesenteric artery... 

Additionally, group 1 of this classification takes into account the proper variations of the common hepatic artery, and reminds the surgeons to take care of the small branches that originate directly from the proper hepatic artery, such as the segment IV artery, which is so important to preserve during split liver transplantation (Chaib et al. 2005 Saylisoy et al. 2005) (Fig. 20.5). 

Fig. 20.5. Variation of the common hepatic artery. 3D-CT angiogram with MIP reconstruction shows the trifurcation of the common hepatic artery...

Embolism of cyanoacrylate occurred in an 87-year-old man occurred 5 days after injection of a bleeding duodenal ulcer with a 5 3 mixture of enbucrilate and lipiodol [25 ]. A CT scan showed linear opacification of the common hepatic artery, its right branch, some splenic branches, and lesions in the head of the pancreas suggestive of infarction. 

Fig. 2.5.3. Celiac angiogram obtained before chemoembolization shows normal anatomy, including common hepatic artery (CHA), splenic artery (SA) and gastroduodenal artery (GDA). Additional multiple small hypervascular tumors (arrows) can he documented...

The classic common hepatic artery (CHA) lies in the hepatoduodenal ligament to the left of the common bile duct and anterior to the portal vein (Lee et al. 2002). In general, the CHA divides into a right and left hepatic artery (Fig. 2.5.4). However, the anatomy of the arterial supply of the liver often shows congenital variations. Common variants of the hepatic artery are having the origin of the left hepatic artery... 

Pad E, Antico E, Candelari R, Alborino S, Marmorale C, Landi E (2000) Pseudoaneurysm of the common hepatic artery treatment with a stent-graft. Cardiovasc Intervent Radiol 23 472-474... 

Fig. 8.3. a Celiac angiogram in a patient with portal hypertension demonstrating a distal splenic artery aneurysm, b Celiac angiogram from another patient with multiple splenic aneurysms associated with portal hypertension who has undergone liver transplantation. Note the large hepatic pseudoaneurysm just medial to the upper pole of the right kidney, c Selective common hepatic artery injection in the patient from b... 

The hepatic and splenic arteries typically arise from the celiac axis, which has its origin at the T12/ LI level of the abdominal aorta. The three main branches of the celiac include the splenic, left gastric, and common hepatic arteries. The splenic artery is typically large and tortuous and supplies small branches to the pancreas. The common hepatic branches into the gastroduodenal and proper hepatic arteries. There is significant variant anatomy of the hepatic arteries Aat the interventionist should be aware of. The most common variation is the replaced right hepatic artery, which arises from the superior mesenteric artery (SMA). This occurs in 12%-15% of the population. Other less frequent variations include the replaced left hepatic from the left gastric artery (11%) and the completely replaced common hepatic from the SMA (2%). 

The gastroduodenal artery arises from the common hepatic artery and supplies branches to the pancreatic head via the superior pancreaticoduodenal arcade (SPDA) and greater curvature of the stomach via the gastroepiploic It is an excellent collateral vessel connecting the celiac to the SMA if either one becomes occluded. 

Hepatic artery aneurysms comprise 20% of all visceral aneurysms [4, 10-12]. Eighty percent are extrahepatic and 20% are intrahepatic. The majority affect the common hepatic artery. Males are affected... 

Selectively embolize gastroduodenal artery to protect No change Decreased Increased normal tissue, then infuse vector via common hepatic artery catheter... 

Fig. 2.6. Volume-rendered 3D reconstruction of celiac trunk and superior mesenteric artery. Anomalous origin of right hepatic artery from superior mesenteric artery is demonstrated (arrow). Left hepatic artery has a normal origin from common hepatic artery (arrowhead)...

In spiral CTHA, contrast material is injected directly into the proper or common hepatic artery. This technique is based on the fact that all but very few HCCs are fed from the hepatic artery. On spiral CTHA images, HCCs show high-attenuation blushes... 

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