Hepatic falciform artery: anatomy, angiographic appearance, and clinical significance.

Williams, David M.; Cho, K J; Ensminger, William D.; Ziessman, H.A.; Gyves, John W.

doi:10.1148/radiology.156.2.3160064

Cited by 63 publications

(39 citation statements)

References 6 publications

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“…In a retrospective study of celiac angiograms performed in 1000 patients, we found an incidence of 18/1000 (unpublished data). Although we have never experienced a supraumbilical skin rash following transcatheter arterial chemotherapy or chemoembolization, and the incidence of this complication is unknown, Williams et al [6] reported that three patients developed supraumbilical skin rashes during hepatic artery infusion chemotherapy through a surgically placed perfusion catheter. In one patient, an hepatic arteriogram showed a dilated falciform branch of the left hepatic artery, and surgical ligation of the falciform artery permitted further treatment without recurrent rash.…”

Section: Discussionmentioning

confidence: 91%

“…The HFA arises as a terminal branch of the left or middle hepatic artery, runs through the hepatic falciform ligament, distributes itself around the umbilicus, and communicates with branches of the internal thoracic and superior epigastric arteries [6,9,10]. As a small artery, the HFA is observed on angiography only about 2% of the time [6].…”

Section: Discussionmentioning

confidence: 99%

“…As a small artery, the HFA is observed on angiography only about 2% of the time [6]. If a patient has developed adhesions around the hepatic falciform ligament after laparotomy, or has a stenosis or occlusion of the hepatic artery, the HFA becomes enlarged and can be demon- strated angiographically [6,10].…”

Section: Discussionmentioning

confidence: 99%

“…With the widespread use of TACE, various complications have been reported [3][4][5]. One such complication is a supraumbilical skin rash caused by the flow of chemotherapy into the hepatic falciform artery (HFA), to date only described for prolonged intraarterial chemotherapy infusion with prevention by surgical ligation of the HFA [6]. We present a patient in whom TACE was safely performed for HCC after transcatheter arterial embolization of the HFA.…”

mentioning

confidence: 99%

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Embolization of the hepatic falciform artery to prevent supraumbilical skin rash during transcatheter arterial chemoembolization for hepatocellular carcinoma

Ueno

Miyazono

Inoue

et al. 1995

Cardiovasc Intervent Radiol

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A dilated hepatic falciform artery (HFA) arising from the left hepatic artery was demonstrated on arteriography prior to chemoembolization of an unresectable hepatocellular carcinoma (HCC) located predominantly in the left lobe of the liver. The HFA was occluded by microcoils to prevent a possible toxic supraumbilical skin rash following chemoembolization of the HCC via the left hepatic artery. There were no postprocedure complications. We consider this procedure useful for improving the safety of chemoembolization.

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Embolization of the hepatic falciform artery to prevent supraumbilical skin rash during transcatheter arterial chemoembolization for hepatocellular carcinoma

Ueno

Miyazono

Inoue

et al. 1995

Cardiovasc Intervent Radiol

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“…This clinical course is very similar to the skin rash that is rarely noted in the supraumbilical region of the patients who undergo a transcatheter infusion chemotherapy or chemoembolization for hepatocellular carcinoma. In those cases, the hepatic falciform artery has been reported to play an important role [4].…”

Section: Discussionmentioning

confidence: 99%

Skin rash in the hypogastric region during a regional chemotherapy for bladder carcinoma: CT and scintigraphic demonstration of a potential collateral pathway between the internal iliac and inferior epigastric arteries

2001

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A 70-year-old man developed a skin rash in his right lower abdominal wall after an intra-arterial infusion chemotherapy for carcinoma of the bladder. A CT with a direct infusion of contrast material via the implanted reservoir showed a marked enhancement of the right inferior epigastric artery and a significantly large artery in the right inguinal region. Radionuclide imaging with a direct infusion of Tc-99m macroaggregated albumin (MAA) revealed an abnormal accumulation in the right anterior abdominal wall. These findings implied a collateral pathway from the right internal iliac artery to the right inferior epigastric artery, i.e., the corona mortis.

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The isolated artery: An intrahepatic arterial pathway that can bypass the lobular parenchyma in mammalian livers

Ekataksin

2000

Hepatology

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Controversy persists concerning the distribution of intrahepatic arterial termination. Apart from nourishing structures in the portal tract, several authors have suggested arterial supply to some isolated vascular beds that bypass the parenchyma, but this was not verified morphologically. In the present study, the existence of an isolated hepatic artery unaccompanied by a portal vein or a bile duct was shown in livers of pigs and other mammals including the dog, seal, ox, horse, and man. After colored media injection, liver blocks were sampled near the hepatic capsule and hepatic vein and subject to histologic assessment. The hepatic artery dissociated from superficial portal tract, ramified, and anastomosed extensively, forming a capsular plexus that drained at places into peripheral sinusoids in which resistive structural elaborations were observed. The artery also dissociated and fed an intramural plexus (vasa vasorum) of hepatic veins. This was collected into a vessel that penetrated the intima into the vein's lumen. In smaller sublobular veins, the plexus emptied into adjacent sinusoids; in central veins, the plexus was poorly developed. In canine and phocine livers, which have a special throttling musculature in sublobular veins, the isolated arterioles were numerous; in bovine and equine livers, which have a thick fibrous investment, the capsular plexus was welldeveloped. Occurrence of the isolated artery also was confirmed in the human but not in the rodent liver. In conclusion, the isolated artery is responsible for isolated vascular beds, in which the transintimal pathway can bypass the lobular sinusoids. (HEPATOLOGY 2000;31:269-279.)There is no definite consensus concerning the distribution and functions of the hepatic artery. Intrahepatic termination of the arteria hepatica propria has been a controversial issue for more than a century. 1 Review of the literature shows that the subject became controversial in 1866, when Chrzonszczewsky, 2 with his classic experiments of selective ligation and injection, observed that branches of the hepatic artery penetrated into the depth of the lobule, and concluded subsequently that the artery nourished the central half of the liver lobule, whereas the portal vein supplied the peripheral half. One hundred years later, in 1966, not only were the statements unsupported, but also many studies extended the controversy about the anatomy 3-7 and physiology 8,9 of intrahepatic arterial distribution. As a result, the clinical and pathological significance of the hepatic artery has remained ill defined, because how the vessel ramifies in the liver has not been accurately described. 10 Microscopic terminations of the hepatic artery are classified into 2 categories, within the portal tract and outside of the portal tract. The former is associated with the formation of periductal plexus and arterioportal anastomosis, 11 whereas the latter is typically related to the distribution of intralobular arterioles. 12 It is the second category that has been most argued. From time to t...

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Hepatic falciform artery: anatomy, angiographic appearance, and clinical significance.

Cited by 63 publications

References 6 publications

Embolization of the hepatic falciform artery to prevent supraumbilical skin rash during transcatheter arterial chemoembolization for hepatocellular carcinoma

Embolization of the hepatic falciform artery to prevent supraumbilical skin rash during transcatheter arterial chemoembolization for hepatocellular carcinoma

Skin rash in the hypogastric region during a regional chemotherapy for bladder carcinoma: CT and scintigraphic demonstration of a potential collateral pathway between the internal iliac and inferior epigastric arteries

The isolated artery: An intrahepatic arterial pathway that can bypass the lobular parenchyma in mammalian livers

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