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15 - Embolization of Liver Tumors: Anatomy

from PART III - ORGAN-SPECIFIC CANCERS

Published online by Cambridge University Press:  18 May 2010

By
Jin Wook Chung  and
Jae Hyung Park
Edited by
Jean-François H. Geschwind  and
Michael C. Soulen
Jin Wook Chung
Affiliation:
Associate Professor, Department of Radiology Seoul National University Hospital Seoul, Korea
Jae Hyung Park
Affiliation:
Professor, Department of Radiology Seoul National University College of Medicine Seoul, Korea
Jean-François H. Geschwind
Affiliation:
The Johns Hopkins University School of Medicine
Michael C. Soulen
Affiliation:
University of Pennsylvania School of Medicine
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Summary

In transcatheter management of hepatic tumors, it is essential to understand hepatic vascular anatomy in detail to enhance therapeutic results and prevent complications due to non-target treatment.

The purpose of this chapter is to review celiac trunk and hepatic artery variations, non-hepatic arteries arising from hepatic arteries and extra-hepatic collateral supply to hepatic tumors.

Celiac Trunk Anatomy

Normal Celiac Trunk Anatomy and Variations

The celiac trunk is a wide branch from the front of the aorta just below the aortic hiatus of the diaphragm. It passes nearly horizontally forward and slightly to the right above the pancreas and the splenic vein, and divides into three major branches of the left gastric artery (LGA), common hepatic artery (CHA) and splenic artery. It may give off one or both inferior phrenic arteries, dorsal pancreatic artery and rarely, colic or jejunal branches (Figure 15.1) (1). The superior mesenteric artery (SMA) separately arises from the aorta inferior to the origin of the celiac axis. Usually, the LGA is the first major branch of the celiac trunk. However, in about 4% of the population, the LGA directly arises from the supraceliac or juxtaceliac aorta, which represents the most common form of celiac trunk variation. If inferior phrenic arteries arise from the celiac trunk, their origin is almost always located proximal to the LGA (Figure 15.1).

Type
Chapter
Information
Interventional Oncology
Principles and Practice
 , pp. 160 - 191
Publisher: Cambridge University Press
Print publication year: 2008

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