Vascular anomalies of the celiac trunk and implications in treatment of HCC with TACE. Description of a case and review of the literature

Silvia Roma, MD; Dejanira D'Amato, MD; Tiziana Ranalli, MD; Vittorio Nardone, MD; Cristina Pace, MD; Ilaria Lenci, MD; Simona Francioso, MD; Arianna Brega, MD; Tommaso Maria Manzia, MD, PhD; Antonio Orlacchio, MD

Radiology Case Reports (Oct 2019)

Vascular anomalies of the celiac trunk and implications in treatment of HCC with TACE. Description of a case and review of the literature

Silvia Roma, MD,
Dejanira D'Amato, MD,
Tiziana Ranalli, MD,
Vittorio Nardone, MD,
Cristina Pace, MD,
Ilaria Lenci, MD,
Simona Francioso, MD,
Arianna Brega, MD,
Tommaso Maria Manzia, MD, PhD,
Antonio Orlacchio, MD

Affiliations

Silvia Roma, MD: Department of Diagnostic and Interventional Radiology, University Hospital Tor Vergata, Viale Oxford 81, Rome 00133, Italy
Dejanira D'Amato, MD: Department of Diagnostic and Interventional Radiology, University Hospital Tor Vergata, Viale Oxford 81, Rome 00133, Italy
Tiziana Ranalli, MD: Department of Diagnostic and Interventional Radiology, University Hospital Tor Vergata, Viale Oxford 81, Rome 00133, Italy
Vittorio Nardone, MD: Department of Diagnostic and Interventional Radiology, University Hospital Tor Vergata, Viale Oxford 81, Rome 00133, Italy
Cristina Pace, MD: Department of Diagnostic and Interventional Radiology, University Hospital Tor Vergata, Viale Oxford 81, Rome 00133, Italy
Ilaria Lenci, MD: Liver Unit, University Hospital Tor Vergata, Viale Oxford 81, Rome 00133, Italy
Simona Francioso, MD: Liver Unit, University Hospital Tor Vergata, Viale Oxford 81, Rome 00133, Italy
Arianna Brega, MD: Liver Unit, University Hospital Tor Vergata, Viale Oxford 81, Rome 00133, Italy
Tommaso Maria Manzia, MD, PhD: Transplant Unit, University Hospital Tor Vergata, Viale Oxford 81, Rome 00133, Italy
Antonio Orlacchio, MD: Department of Diagnostic and Interventional Radiology, University Hospital Tor Vergata, Viale Oxford 81, Rome 00133, Italy; Corresponding author.

Journal volume & issue: Vol. 14, no. 10
pp. 1221 – 1227

Abstract

Read online

Knowledge of the vascular anatomy of the upper abdomen is important in the daily practice of surgeons specialized in the hepatobiliary and pancreatic area, and for general surgeons and radiologists, mainly those involved in interventional radiology. Since anatomical variants of the celiac axis and hepatic arteries are common, an accurate description of vascularization is required before procedures to avoid iatrogenic vascular changes.We reported a case of a young male patient with HBV related cirrhosis, who came to our institution for the treatment of 2 HCC nodules. The preprocedural contrast-enhanced CT examination showed combined variations of celiac trunk, hepatic arteries, gastroduodenal artery, and right inferior phrenic artery. The careful pre- and intraprocedural evaluation of vascularization allowed us to perform transarterial chemoembolization of the 2 nodules without complications.The incidence and developmental and clinical significance of this variation is discussed with a detailed review of the literature. Knowledge of such a case has important clinical significance in abdominal operations or invasive arterial procedures. Keywords: Celiac trunk, Hepatic artery, Gastroduodenal artery, Right inferior phrenic artery, Common hepatic artery absence

Published in Radiology Case Reports

ISSN: 1930-0433 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Medicine (General): Medical physics. Medical radiology. Nuclear medicine
Website: https://www.sciencedirect.com/journal/radiology-case-reports

About the journal