Hepatic falciform artery: angiographic observations and significance

Gibo, Masaki; Hasuo, K; Miura, Naruhisa; Murata, Shigetoshi

doi:10.1007/s002610000207

Cited by 39 publications

(23 citation statements)

References 7 publications

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“…Since late-2009, our institution has routinely performed SPECT/CT after liver-lung shunt scintigraphy. Our incidence of falciform ligament radiotracer activity detected on SPECT/ CT is 10% (5 out of 51 patients), in keeping with reported angiographic incidence [8][9][10][11][12][13]. However, this is likely an under-representation as some of our patients do not undergo whole-liver injection of Tc-99m-MAA.…”

Section: Discussionsupporting

confidence: 85%

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Hepatic falciform ligament Tc-99m-macroaggregated albumin activity on SPECT/CT prior to Yttrium-90 microsphere radioembolization: prophylactic measures to prevent non-target microsphere localization via patent hepatic falciform arteries

et al. 2011

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Yttrium-90 (Y-90) selective internal radiation therapy (SIRT) is increasingly used to treat inoperable hepatocellular carcinoma. We describe two patients where hepatic falciform ligament Technetium-99m-macroaggregated albumin (Tc-99m-MAA) activity was identified on single photon emission computed tomography with integrated low-dose CT (SPECT/CT) scan during pre-therapy planning, and the steps taken to prevent radiation dermatitis. The first patient underwent prophylactic coil embolization of the patent hepatic falciform artery; the second patient underwent super-selective infusion of Y-90 resin microspheres to avoid the patent hepatic falciform artery. The incidence of falciform ligament Tc-99m-MAA activity detected on SPECT/CT at our institution is 10%. Tc-99m-MAA SPECT/CT scan provides valuable diagnostic information for treatment planning prior to Y-90 SIRT.

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Section: Discussionsupporting

confidence: 85%

“…The angiographic incidence of a patent hepatic falciform artery ranges from 2 to 24.5% [8][9][10][11][12][13]. Since late-2009, our institution has routinely performed SPECT/CT after liver-lung shunt scintigraphy.…”

Section: Discussionmentioning

confidence: 99%

Hepatic falciform ligament Tc-99m-macroaggregated albumin activity on SPECT/CT prior to Yttrium-90 microsphere radioembolization: prophylactic measures to prevent non-target microsphere localization via patent hepatic falciform arteries

et al. 2011

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“…The frequency reported by Song was higher, which might be caused by larger volume and quicker injection of contrast agent, or by selective angiography of the left hepatic artery. It was reported that chemoembolization of this artery would cause reaction of the umbilical skin [15,17] , which was not observed in our study. We believe that the hepatic falciform artery is a residual artery from the embryo that supplies blood from liver to the umbilical tissues.…”

Section: Discussioncontrasting

confidence: 80%

Angiographic findings of extrahepatic branches originating from hepatic artery and its clinical significance

Wang

2009

Chin. J. Cancer Res.

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Objective: To observe the presentation and variation of extrahepatic branches originating from hepatic artery by hepatic arteriography.Methods: Hepatic arteriogram of 200 cases with unresectable hepatic primary or metastatic tumors before interventional therapy were retrospectively analyzed. Two interventional radiologists independently reviewed the type, originating artery, distribution and variation of extrahepatic artery.Results: Five types of extrahepatic artery were found, with the most common type of the right gastric artery (n=156, 78%), followed by the cystic artery (n=126, 63%), accessory left gastric artery (n=19, 9.5%), hepatic falciform artery (n=5, 2.5%), and accessory left inferior phrenic artery (n=4, 2%). In 188 cases, there were extrahepatic arteries derived from hepatic proper artery or its branches, and the most frequent originating site was the right hepatic artery (130 extrahepatic branches), followed by the proper hepatic artery (103 branches), left hepatic artery (56 branches) and middle hepatic artery (3 branches). The left hepatic artery was the arising site with the multiple types of extrahepatic branches including all above branches except the cystic artery.Conclusion: Many types of extrahepatic branches usually derive from the hepatic artery or its distal branches, and its originating sites are not constant. It is important to avoid damage of extrahepatic tissue during interventional therapy for liver tumors.

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“…While high incidence of HFA (67.2%) was reported on postmortem anatomic dissections, the reported incidences of HFA on angiography were low (ranging from 2% to 24.5%) [7-9]. One of the reasons for these discrepancies seems to be the velocity of arterial flow.…”

Section: Discussionmentioning

confidence: 99%

“…One of the reasons for these discrepancies seems to be the velocity of arterial flow. The flow was often too slow to be regularly detected during the early arterial phase on angiography [9]. The similarity of the HFA route with those of other arteries might be another reason.…”

Section: Discussionmentioning

confidence: 99%

A case of hepatocellular carcinoma with skin injury of the upper abdominal wall after transcatheter arterial chemoembolization: a case report

Kanzaki¹,

Nouso²,

Miyahara³

et al. 2009

Cases J

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IntroductionTranscatheter arterial chemoembolization has been widely used to treat advanced hepatocellular carcinoma that cannot be treated by local ablation therapies or surgical resection. The effectiveness of transcatheter arterial chemoembolization in prolonging survival has been well established, and approximately one third of newly discovered hepatocellular carcinoma patients were repeatedly treated by transcatheter arterial chemoembolization in Japan. Various kinds of complications have been reported, and many of which are general complications such as hepatic coma, jaundice, fever-up, ascites, and bile duct injury.The hepatic falciform artery is found frequently during postmortem anatomic dissection and the incidence of hepatic falciform artery is reported to be over 60%. Hepatic falciform artery is known to be the responsible artery for supraumbilical skin rash development after arterial chemo infusion therapy; however, skin complications after transcatheter arterial chemoembolization are rare.Case presentationA 70-year-old female with chronic hepatitis C infection was diagnosed as having hepatocellular carcinoma (S4, 20 mm in diameter). Transcatheter arterial chemoembolization was performed via the left hepatic artery, which was a feeding artery of the hepatocellular carcinoma. Two days after that, supraumbilical skin rash with local tenderness and redness appeared. Retrospective analysis revealed that occlusion of the hepatic falciform artery branching from the left hepatic artery with micromaterials caused the skin lesion.ConclusionWe should keep in mind that anticancer drugs or embolic materials can flow into the HFA and may cause abdominal wall injury after transcatheter arterial chemoembolization.

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Hepatic falciform artery: angiographic observations and significance

Abstract: The angiographic incidence of the HFA is more common than previously reported. The delayed and persistent opacification of the HFA on hepatic angiograms caused by its slow blood flow is considered the key to its identification.

Cited by 39 publications

References 7 publications

Hepatic falciform ligament Tc-99m-macroaggregated albumin activity on SPECT/CT prior to Yttrium-90 microsphere radioembolization: prophylactic measures to prevent non-target microsphere localization via patent hepatic falciform arteries

Hepatic falciform ligament Tc-99m-macroaggregated albumin activity on SPECT/CT prior to Yttrium-90 microsphere radioembolization: prophylactic measures to prevent non-target microsphere localization via patent hepatic falciform arteries

Angiographic findings of extrahepatic branches originating from hepatic artery and its clinical significance

A case of hepatocellular carcinoma with skin injury of the upper abdominal wall after transcatheter arterial chemoembolization: a case report

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