Arterial blood supply to the caudate lobe of the liver from the proximal branches of the right inferior phrenic artery in patients with recurrent hepatocellular carcinoma after chemoembolization

Miyayama, Shiro; Yamashiro, Masashi; Shibata, Yoshihiro; Hashimoto, Masahiro; Yoshida, Midori; Tsuji, Kiichiro; Toshima, Fumihito; Matsui, Osamu

doi:10.1007/s11604-011-0007-x

Cited by 9 publications

(3 citation statements)

References 19 publications

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“…Extrahepatic collateral arteries frequently supply recurrent tumors in the caudate lobe, mainly owing to the potential anastomosis between the caudate artery and retroperitoneal arteries within the bare area of the liver (24). The most common of these vessels is the right inferior phrenic artery (25,26).…”

Section: Recurrent Tumors In the Caudate Lobementioning

confidence: 99%

Selective Chemoembolization of Caudate Lobe Hepatocellular Carcinoma: Anatomy and Procedural Techniques

2019

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Transarterial chemoembolization is the most common treatment for unresectable hepatocellular carcinomas (HCCs). However, when an HCC is located in the caudate lobe, many interventional radiologists are reluctant to perform chemoembolization and percutaneous ablation owing to the tumor's complex vascular supply and deep location. With the advent of C-arm CT, rendering the three-dimensional display of the hepatic artery and detecting the tumor-feeding vessels are possible and can help guide interventional radiologists to the tumor. The common origins of the caudate artery include the right hepatic artery, left hepatic artery, right anterior hepatic artery, and right posterior hepatic artery. The origins of the tumor-feeding arteries of a caudate lobe HCC can vary depending on the tumor's subsegmental location. Caudate lobe HCCs are commonly fed by multiple caudate arteries that are connected. In addition, extrahepatic collateral arteries frequently supply recurrent tumors in the caudate lobe. The caudate artery can supply portal vein thrombi or biliary tumor thrombi in patients with HCC. Several techniques such as preshaping the microcatheter or using the shepherd's hook technique are needed to catheterize the caudate artery in complex cases. Although uncommon, bile duct stricture is a serious complication following selective chemoembolization through the caudate artery. Identification and catheterization of the caudate artery have become possible in most patients by using C-arm CT and a fine microcatheter system, respectively. The authors review the anatomy of the caudate artery with C-arm CT and describe basic technical considerations in selective chemoembolization for caudate lobe HCCs. Unusual circumstances that require catheterization and techniques used for catheterizing the caudate artery are also described.

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Section: Recurrent Tumors In the Caudate Lobementioning

confidence: 99%

Selective Chemoembolization of Caudate Lobe Hepatocellular Carcinoma: Anatomy and Procedural Techniques

2019

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“…It is well known that the right IPA occasionally supplies the tumor in the caudate lobe [17][18][19][20][23][24][25][26][27]. The first branch of the right IPA, called the suprarenal branch, mainly supplies the dorsal part of SP, together with branches arising from the main trunk or from the proximal portion of the anterior (ascending) and posterior (descending) branches [24,25]. These branches penetrate the IVC ligament and run around the IVC, and finally reach the caudate lobe (Fig.…”

Section: Blood Supply To the Caudate Lobe From The Extrahepatic Arterymentioning

confidence: 99%

Radiological Vascular Anatomy of the Caudate Lobe of the Liver Required for Transarterial Chemoembolization of Hepatocellular Carcinoma

Miyayama

2023

Interventional Radiology

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The caudate lobe is located between the bilateral hepatic lobes and is divided into three subsegments: the Spiegel lobe, paracaval portion, and caudate process. The caudate artery arises from various sites of the bilateral hepatic arteries as an independent branch, common trunk, or arcade. Extrahepatic arteries can enter the caudate lobe mainly by the right inferior phrenic artery. The caudate artery also supplies the main bile duct and posterior aspect of segment IV. Although catheterization into the caudate artery is occasionally difficult because of its small size and sharp angulation, selective embolization of a tumor feeder is a significant prognostic factor in patients with hepatocellular carcinoma originating there. Therefore, we should recognize the peculiarity of its vascular anatomy and should be familiar with catheterization and embolization techniques.

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“…The caudate arteries can initially originate from the extrahepatic arteries, 12 and the right inferior phrenic artery (RIPA) is the most common extrahepatic artery. 12 , 13 , 14 Other less common vessels supplying recurrent tumors include the right gastric artery, the left gastric artery, the pancreatic artery and the adrenal artery. 5 , 7 , 11 The possibility of extrahepatic arterial supply, such as the RIPA, should therefore not be overlooked during hepatic arteriography.…”

Section: Transcatheter Arterial Chemoembolizationmentioning

confidence: 99%

Advances in the interventional therapy of hepatocellular carcinoma originating from the caudate lobe

2022

Journal of Interventional Medicine

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Arterial blood supply to the caudate lobe of the liver from the proximal branches of the right inferior phrenic artery in patients with recurrent hepatocellular carcinoma after chemoembolization

Abstract: The proximal RIPA branches mainly supply the SP when A1 is attenuated.

Cited by 9 publications

References 19 publications

Selective Chemoembolization of Caudate Lobe Hepatocellular Carcinoma: Anatomy and Procedural Techniques

Selective Chemoembolization of Caudate Lobe Hepatocellular Carcinoma: Anatomy and Procedural Techniques

Radiological Vascular Anatomy of the Caudate Lobe of the Liver Required for Transarterial Chemoembolization of Hepatocellular Carcinoma

Advances in the interventional therapy of hepatocellular carcinoma originating from the caudate lobe

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