Collateral arterial pathways to the liver after ligation of the hepatic artery and removal of the celiac axis

Michels, Nicholas A.

doi:10.1002/1097-0142(195307)6:4<708::aid-cncr2820060411>3.0.co;2-a

Cited by 170 publications

(52 citation statements)

References 25 publications

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“…The compensatory arterial circulation to the liver after TAE for the treatment of ruptured hepatic artery pseudoaneurysm was recognized in 8 of the 9 patients who underwent major hepatobiliary pancreatic surgery in this study. Michels has described the details of extrahepatic arterial collaterals to the liver after ligation of the hepatic artery in a series of 200 cases of hepatic resection, in which at least 26 possible routes of collateral arterial blood supply to the liver from the common hepatic trunk were noted [19] . Among them, the following are clinically important: (1) the subphrenic branch of the phrenic artery or internal mammary artery, (2) the aberrant hepatic artery, (3) the periductal arterial plexus, (4) other collaterals into the hepatic hilum from the superior mesenteric artery, and (5) the intrahepatic branches [19,20] .…”

Section: Discussionmentioning

confidence: 99%

“…Michels has described the details of extrahepatic arterial collaterals to the liver after ligation of the hepatic artery in a series of 200 cases of hepatic resection, in which at least 26 possible routes of collateral arterial blood supply to the liver from the common hepatic trunk were noted [19] . Among them, the following are clinically important: (1) the subphrenic branch of the phrenic artery or internal mammary artery, (2) the aberrant hepatic artery, (3) the periductal arterial plexus, (4) other collaterals into the hepatic hilum from the superior mesenteric artery, and (5) the intrahepatic branches [19,20] . Although the significance of extrahepatic collateral pathways in association with liver damage after hepatic TAE has been reported [2,[21][22][23] , the relationship between the primary surgical procedure and the development of extrahepatic collaterals following hepatobiliary pancreatic surgery has not been described in detail.…”

Section: Discussionmentioning

confidence: 99%

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Extrahepatic collaterals and liver damage in embolotherapy for ruptured hepatic artery pseudoaneurysm following hepatobiliary pancreatic surgery

Tajima

Kuroki²,

Tsutsumi³

et al. 2007

WJG

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AIM:To evaluate the effects of extrahepatic collaterals to the liver on liver damage and patient outcome after embolotherapy for the ruptured hepatic artery pseudoaneurysm following hepatobiliary pancreatic surgery. METHODS:We reviewed 9 patients who underwent transcatheter arterial embolization (TAE) for the ruptured hepatic artery pseudoaneurysm following major hepatobiliary pancreatic surgery between June 1992 and April 2006. We paid special attention to the extrahepatic arterial collaterals to the liver which may affect post-TAE liver damage and patient outcome. RESULTS:The underlying diseases were all malignancies, and the surgical procedures included hepatopancreatoduodenectomy in 2 patients, hepatic resection with removal of the bile duct in 5, and pancreaticoduodenectomy in 2. A total of 11 pseudoaneurysm developed: 4 in the common hepatic artery, 4 in the proper hepatic artery, and 3 in the right hepatic artery. Successful hemostasis was accomplished with the initial TAE in all patients, except for 1. Extrahepatic arterial pathways to the liver, including the right inferior phrenic artery, the jejunal branches, and the aberrant left hepatic artery, were identified in 8 of the 9 patients after the completion of TAE. The development of collaterals depended on the extent of liver mobilization during the hepatic resection, the postoperative period, the presence or absence of an aberrant left hepatic artery, and the concomitant arterial stenosis adjacent to the pseudoaneurysm. The liver tolerated TAE without significant consequences when at least one of the collaterals from the inferior phrenic artery or the aberrant left hepatic artery was present. One patient, however, with no extrahepatic collaterals died of liver failure due to total liver necrosis 9 d after TAE. CONCLUSION:When TAE is performed on ruptured hepatic artery pseudoaneurysm, reduced collateral pathways to the liver created by the primary surgical procedure and a short postoperative interval may lead to an unfavorable outcome.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Extrahepatic collaterals and liver damage in embolotherapy for ruptured hepatic artery pseudoaneurysm following hepatobiliary pancreatic surgery

Tajima

Kuroki²,

Tsutsumi³

et al. 2007

WJG

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“…Extrahepatic collateral supplies to P-HCC are established under various conditions (15-17). These collateral supplies may develop following the interruption of the hepatic artery by surgical ligation, arterial injury induced by repeated TACE or the placement of a catheter (15)(16)(17). Adhesions between tumors protruding from the liver and adjacent organs can exaggerate the degree of extrahepatic collateral blood supplies, although the hepatic arterial supply remains intact (3,15,(18)(19)(20)(21)(22).…”

Section: Discussionmentioning

confidence: 99%

Blood supply characteristics of pedunculated hepatocellular carcinoma prior to and following transcatheter arterial chemoembolization treatment: An angiographic demonstration

et al. 2018

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Abstract. Pedunculated hepatocellular carcinoma (P-HCC) is a rare type of HCC, defined as a carcinoma protruding from the liver with or without a pedicle with a low degree of liver invasion. The present study aimed to evaluate the characteristics of blood supply of P-HCC prior to and following transcatheter arterial chemoembolization (TACE) treatment. Angiographic findings prior to and following TACE treatment in 39 patients with P-HCC were analyzed retrospectively. Angiography performed at the first TACE session revealed 70 tumor-feeding arteries collectively in all patients, including 31/70 (44.0%) extrahepatic parasitic arteries in 23/39 patients (59.0%). The intrahepatic arteries served as the main blood supply to P-HCC in all patients. Extrahepatic collateral blood supplies to P-HCCs were significantly associated with larger tumor diameter (χ 2 =164.000, P<0.001), but not tumor location (χ 2 =7.358, P=0.061). Following repeated TACE treatment, all angiographies revealed a total of 131 tumor feeding arteries collectively in all patients, including intrahepatic arteries (54/131) and extrahepatic collateral arteries (78/131) in 31 patients (79.5%). Compared with angiographies performed at the initial TACE treatment, these results also demonstrated an increase in the number of extrahepatic collateral arteries, which produced 47 new blood vessels (χ 2 = 4.278, P= 0.039). P-HCC tumor lesions readily acquired a parasitic blood supply from adjacent vessels following repeated TACE. Intrahepatic arteries functioned as the main blood supply for P-HCC, whereas extrahepatic collateral arteries were complementary to P-HCC, regardless of whether the patient was pre-or post-TACE. Extrahepatic collateral supplies to P-HCCs that originated from adjacent vessels were rich, were closely associated with tumor size, and were prone to be newly established following repeated TACE. IntroductionPedunculated hepatocellular carcinoma (P-HCC) is a rare type of HCC, which is defined as a carcinoma protruding from the liver with or without a pedicle, and with a low degree of liver invasion (1). P-HCC was first described by Roux in 1897 (2), and represents 0.24-3.00% of all cases of HCC in Japan (3,4). Additionally, to the best of our knowledge, <200 cases have been reported in previous studies (4-6).The majority of P-HCC cases are treated surgically, with higher operability rates and better survival than conventional HCC, which may be due to its unique growth pattern, high rate of tumor capsule formation and lower vascular invasion (4-6). However, up to 39.4% of patients with P-HCC are unable to undergo surgical resection (7). Therefore, palliative treatments may serve a central function in the treatment of unresectable P-HCC. Transcatheter arterial chemoembolization (TACE) is the most widely used locoregional therapy for patients with intermediate HCC, who cannot be treated surgically (8-11). However, the blood supply to P-HCC is complicated, arising from hepatic arteries and extrahepatic collateral vessels (3). P-HCC tumor lesions prot...

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“…A branch of the IMA enters the liver within the hepatic falciform ligament and anastomoses with peripheral branches of the hepatic artery. Extrahepatic collaterals tend to develop in the ligaments that support the liver [2,3]. Collaterals from the right IMA after TAE of the hepatic artery have been reported [4,5].…”

Section: Discussionmentioning

confidence: 99%

“…No complications resulted from the procedure. The left IMA should be considered as a possible feeding artery to an HCC occurring in the anterior portion of the left hepatic lobe.It is well recognized that following transarterial embolization (TAE) for hepatocellular carcinoma (HCC), collateral arterial supply will develop, particularly extrahepatic collaterals including the internal mammary artery (IMA) [1][2][3]. Recurrent HCCs supplied from the right IMA after TAE have been described [4,5].…”

mentioning

confidence: 99%

Left Lobe Recurrent Hepatocellular Carcinoma Treated with Lipiodol-TAE via the Left Internal Mammary Artery

Kanetsuki

Hori

Ohshiro

et al. 1997

Cardiovasc Intervent Radiol

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A multinodular hepatocellular carcinoma (HCC) was treated with seven transarterial interventions via the hepatic artery over a 2-year, 5-month period before the eighth angiography showed a recurrent HCC in the anterior portion of the left hepatic lobe. The left internal mammary artery (IMA) was feeding the tumor. This was successfully treated with Lipiodol-transcatheter arterial embolization using a coaxial system via a branch of the left IMA. No complications resulted from the procedure. The left IMA should be considered as a possible feeding artery to an HCC occurring in the anterior portion of the left hepatic lobe.

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Collateral arterial pathways to the liver after ligation of the hepatic artery and removal of the celiac axis

Cited by 170 publications

References 25 publications

Extrahepatic collaterals and liver damage in embolotherapy for ruptured hepatic artery pseudoaneurysm following hepatobiliary pancreatic surgery

Extrahepatic collaterals and liver damage in embolotherapy for ruptured hepatic artery pseudoaneurysm following hepatobiliary pancreatic surgery

Blood supply characteristics of pedunculated hepatocellular carcinoma prior to and following transcatheter arterial chemoembolization treatment: An angiographic demonstration

Left Lobe Recurrent Hepatocellular Carcinoma Treated with Lipiodol-TAE via the Left Internal Mammary Artery

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