Long-term Hepatic Arterial Infusion Chemotherapy

Daly, J.M.; Kemeny, Nancy E.; Oderman, Paula; Botet, José

doi:10.1001/archsurg.1984.01390200054013

Cited by 123 publications

(27 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…After Michels 3 initial classification, several authors described their own observations. [4][5][6] From a surgical point of view, we believe that Michels 3 initial classification is more complete since it establishes the differences between "an accessory" and "a replaced" artery, concepts not explained in more recent classifications. That is the main reason we choose it in the present study.…”

Section: Discussionmentioning

confidence: 91%

“…[3][4][5]8,10,12 Michels 3 reported in 1966 a classification of 10 possible anatomical variants of the extrahepatic arterial distribution that was based on a study of 200 autopsy cases. After Michels 3 initial classification, several authors described their own observations.…”

Section: Discussionmentioning

confidence: 99%

“…These studies are based on angiographic data and autopsy dissections, and mainly derive from surgery and transplantation literature. [4][5][6][7][8][9][10][11][12][13][14] The large sample size of transplanted livers is one of the major interests of this study. Indeed, harvested livers offer an excellent opportunity to describe, in situ, the anatomic variants of the arteries since all extrahepatic arteries need to be carefully identified during this step of the liver transplantation procedure to avoid injuries that jeopardize the viability of the graft once implanted.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Lessons learned from anatomic variants of the hepatic artery in 1,081 transplanted livers

et al. 2007

View full text Add to dashboard Cite

The aim of this study is to contribute our experience to the knowledge of the anatomic variations of the hepatic arterial supply. The surgical anatomy of the extrahepatic arterial vascularization was investigated prospectively in 1,081 donor cadaveric livers, transplanted at La Fe University Hospital from January 1991 to August 2004. The vascular anatomy of the hepatic grafts was classified according to Michels description (Am J Surg 1966;112:337-347) plus 2 variations. Anatomical variants of the classical pattern were detected in 30% of the livers (n ϭ 320). The most common variant was a replaced left artery arising from the left gastric artery (9.7%) followed by a replaced right hepatic artery arising from the superior mesenteric artery (7.8%). In conclusion, the information about the different hepatic arterial patterns can help in reducing the risks of iatrogenic complications, which in turn may result in better outcomes not only following surgical interventions but also in the context of radiological treatments. Knowledge of hepatic arterial vascularization has a significant relevance for the daily practice of a wide range of practitioners including not only surgeons specialized in the hepato-biliary-pancreatic area, but also general surgeons and radiologists, mainly those who are dedicated to interventional radiologic treatments.In the last few years, substantial improvements have been achieved in the surgical and/or radiological treatment of benign and malignant liver, pancreatic, and biliary diseases. With laparoscopic surgery the need has arisen for exact descriptions of the hepatic vascularization to avoid iatrogenic vascular lesions.In the setting of liver transplantation, the most effective approach to reduce the dropout rate on the waiting lists is to expand the number of available livers. Several strategies including living donors and split livers have been developed for this purpose. These are extremely complex techniques in which the exact knowledge of the arterial anatomy is a required step to plan the best resection as well as to minimize the risks of morbidity.The patterns of hepatic arterial supply are not constant. The usual anatomy of the hepatic arterial vascularization is a common hepatic artery arising from the celiac axis, accounting for 25 to 75% of the cases. 1 In the variant patterns, the hepatic lobes receive arterial flow through branches coming from the superior mesenteric artery, left gastric artery, or, rarely, from other arterial trunks. 2 Since Michels 3 published his first report, several studies have reported not only common and rare hepatic artery variants, but also different classifications. These studies are based on angiographic data and autopsy dissections, and mainly derive from surgery and transplantation literature. [4][5][6][7][8][9][10][11][12][13][14] The large sample size of transplanted livers is one of the major interests of this study. Indeed, harvested livers offer an excellent opportunity to describe, in situ, the anatomic variants of the arteries since all e...

show abstract

Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Lessons learned from anatomic variants of the hepatic artery in 1,081 transplanted livers

et al. 2007

View full text Add to dashboard Cite

show abstract

“…Based on a literature review, the most commonly observed variation of the hepatic artery was the one originating from the SMA (Type III: 6-15.5%),followed by Type II in which the left hepatic artery arose from the LGA (24,25). The incidence of this type is between 2.5% and 10% in studies till date.…”

Section: Discussionmentioning

confidence: 99%

Anatomic variations of the celiac trunk and hepatic arterial system with digital subtraction angiography

Zağyapan

Kürkçüoğlu²,

Bayraktar³

et al. 2015

Turk J Gastroenterol

View full text Add to dashboard Cite

Background/Aims: Anatomical variation of the abdominal arteries is important. Historic and modern anatomists, radiologists, as well as surgeons have reported and accumulated anatomical variations with a morphological and clinical interest. During graft procurement and reconstruction, accidental injury of the hepatic artery is more likely in the presence of hepatic arterial variation, which can be a common clinical entity. During cadaveric dissection and diagnostic radiological imaging, various types of vascular anomalies are frequently found in human abdominal viscera, especially the celiac trunk. The aim of the present study is to determine anatomical variations in the celiac trunk and hepatic arterial system. Materials and Methods: Digital subtraction angiography data were collected from 152 consecutive donor patients (103 males and 49 females, aged between 6 and 77 years) who underwent orthotopic liver transplantation. Results: We examined the anatomy of the celiac trunk in a total of 152 consecutive patients. In total, 62.5% (95/152) of patients showed the classical trifurcation of the celiac trunk. Variant right hepatic arteries arising from the superior mesenteric artery were observed in 17.8% (27/152), the hepatic arteries arising from the left gastric artery were found in 13.1% (20/152), and common hepatic arteries arising from the superior mesenteric artery were observed in 6.6% (10/152) of patients. Conclusion: These data are useful for planning and performing surgical and radiological procedures of the upper abdomen.

show abstract

“…Conclusion -Hepatic artery variations allowed liver section into right and left hepatic lobe. própria subdividindo-se em AHD e AHE, neste estudo 68,3% dos casos e na literatura variando de 57% a 80% (1,19,24,26,29,31,36,37) . Um ponto muito importante refere-se à irrigação do segmento IV, que neste estudo encontrou-se em dois (3,3%) casos de dupla irrigação arterial o que poderia, em caso de lesões inadvertidas, prejudicar a utilização do lobo esquerdo em transplantes reduzidos ou mesmo na modalidade de bipartição hepática.…”

Section: Discussionunclassified

Variações do sistema arterial hepático e sua aplicabilidade na bipartição do fígado: estudo anatômico em cadáveres

Bertevello

Chaib

2002

Arq. Gastroenterol.

View full text Add to dashboard Cite

RESUMO -Racional -Com a escassez de doadores de órgãos e com o aumento da demanda para o transplante de fígado, faz-se necessário aplicação de técnicas cirúrgicas avançadas para viabilização e melhor aproveitamento dos fígados disponíveis, como a chamada técnica da bipartição do fígado, onde de um doador se consegue fazer dois transplantes hepáticos, geralmente um adulto e uma criança. Objetivos -Estudar detalhadamente a distribuição arterial em sua porção extra e intra-hepática e suas implicações na secção regrada do fígado em dois segmentos anatomicamente equivalentes (lobo esquerdo e lobo direito). Material e Métodos -Estudo de 60 fígados provenientes de cadáver fresco, examinando a artéria hepática e suas ramificações, bem como suas variações anatômicas. A secção hepática foi realizada em duas metades: lobo direito e esquerdo. Resultados -O peso total do fígado foi de 1536 ± 361,8 g, do lobo direito 890,3 ± 230,9 g e do esquerdo 649,3 ± 172,6 g. Em 1 (1,6%) caso, o tronco hepático comum, era proveniente da artéria mesentérica superior, e em outro (1,6%), a artéria hepática esquerda era proveniente da aorta abdominal. A artéria hepática direita era proveniente do tronco celíaco em 44 (73,3%) casos, em 15 (25%) era oriunda da artéria mesentérica superior, sendo que em 11 (18,3%) casos era acessória e em 4(6,6%) era dominante. A artéria hepática esquerda era acessória da artéria gástrica esquerda em 2 (3,3%) casos. Em 9 (15%) casos houve trifurcação da artéria hepática própria, originando a artéria hepática média, que ficou assim distribuída: 6 (10%) casos como tronco único para o segmento IV, em 2 (3,3%) casos para o segmento III e 1 (1,6%) para o segmento II. Em 2 (3,3%) casos, ocorreram 2 artérias hepáticas médias que irrigavam o segmento IV. Conclusão -As variações anatômicas da artéria hepática não impediram a secção do parênquima hepático em lobo direito e esquerdo. DESCRITORES - INTRODUÇÃONa prática clínica diversos estágios da doença hepática são encontrados e o transplante hepático tem sido aceito como terapêutica definitiva para adultos e crianças em fase terminal das hepatopatias (7) .O transplante de fígado foi introduzido por STARZL et al. (39) e desde então, muitas dificuldades foram superadas (6,9,10,13) , porém a maior limitação para a sua aplicabilidade tem sido a falta de doadores de órgãos (14,27) .O estudo detalhado da anatomia das estruturas do fígado tanto intra, como extra-hepáticas (8,11,12) permitiu, nos últimos anos, o desenvolvimento com sucesso de técnicas alternativas de transplante hepático, como o transplante de fígado reduzido (2,4,32) , o chamado "split-liver" ou bipartição hepática (33) e recentemente o ransplante intervivos (34) .Em particular, na técnica de bipartição do fígado, com um fígado podemos obter dois enxertos (lobo direito e lobo esquerdo hepático), beneficiando, assim, dois receptores, técnica desenvolvida por PILCHLMAYR et al. (33) .A técnica difundiu-se, rapidamente, em diversos centros na Europa e Estados Unidos, diminuindo um pouco a demanda por doadores (17,...

show abstract

Long-term Hepatic Arterial Infusion Chemotherapy

Cited by 123 publications

References 15 publications

Lessons learned from anatomic variants of the hepatic artery in 1,081 transplanted livers

Lessons learned from anatomic variants of the hepatic artery in 1,081 transplanted livers

Anatomic variations of the celiac trunk and hepatic arterial system with digital subtraction angiography

Variações do sistema arterial hepático e sua aplicabilidade na bipartição do fígado: estudo anatômico em cadáveres

Contact Info

Product

Resources

About