Mesenteric and renal angiography
Debabrata Mukherjee, Eric R. Bates, Marco Roffi, Richard A. Lange, David J. Moliterno, Nadia M. Whitehead in Cardiovascular Catheterization and Intervention, 2017
The mesenteric arteries arise from the anterior aspect of the lower thoracic and abdominal aorta. These vessels—the celiac trunk, superior mesenteric artery (SMA), and inferior mesenteric artery (IMA)—are responsible for the blood supply to all organs located within the abdominal cavity. The celiac trunk is the first major branch of the abdominal aorta and is an essential source of blood supply to the liver, stomach, and parts of the esophagus, spleen, duodenum, and pancreas. Its origin from the anterior aorta is typically midline at the level of the T12 vertebral body, and it courses inferiorly for 1-2 cm before branching into the left gastric, common hepatic, and splenic arteries (Figure 24.1). The common hepatic artery divides into the proper hepatic artery and, typically, also the gastroduodenal artery. The proper hepatic gives off the right gastric artery before branching into the right and left hepatic arteries. The gastroduodenal artery then goes on to divide into the right gastroepiploic artery and the anterior and posterior superior pancreaticoduodenal arteries. The right gastroepiploic artery and the left gastroepiploic artery (from the splenic artery) join together along the greater curvature of the stomach. The right gastric artery and the left gastric artery join together to run along the lesser curvature of the stomach. Because of the redundant blood supply to the stomach, gastric ischemia is uncommon.
Abdomen
David Heylings, Stephen Carmichael, Samuel Leinster, Janak Saada, Bari M. Logan, Ralph T. Hutchings in McMinn’s Concise Human Anatomy, 2017
Coeliac trunk - arises at the point where the aorta enters the abdomen to supply the foregut and associated organs and is usually a very short vessel that divides immediately into three branches: the left gastric, splenic and common hepatic arteries. The left gastric artery passes upwards on the diaphragm and to the left to reach the oesophagus and then descends on the lesser curvature of the stomach and gives off an oesophageal branch. The splenic artery runs on the posterior abdominal wall to the left along the upper border of the pancreas to the spleen, at which point it gives off the left gastroepiploic and short gastric arteries to the left side of the greater curvature and fundus of the stomach. The common hepatic artery passes on the posterior abdominal wall to the right and gives off the right gastric artery to the lesser curvature and the gastroduodenal artery (which in turn gives off the right gastroepiploic [on the greater curvature] and superior pancreaticoduodenal arteries). The common hepatic artery then turns cranially as the (proper) hepatic artery (also an origin for the right gastric artery) in the right free margin of the lesser omentum to reach the liver (p. 175); note the change of name from common hepatic to hepatic.
Complications of Pancreatic Surgery and Trauma
Stephen M. Cohn, Matthew O. Dolich in Complications in Surgery and Trauma, 2014
The arterial and venous anatomies are relatively constant in the pancreas; however, knowledge of the main vascular branches is important when the gland is to be dissected and particularly when such dissection occurs near the portal triad. The common hepatic artery traverses the superior border of the pancreas toward the portal triad. It divides to form the proper hepatic artery and the gastroduodenal artery. The gastroduodenal artery descends retrograde and within the gland itself. In about 15% of cases, there is an aberrant right hepatic artery directly off the superior mesenteric artery. Whether this artery is replaced or aberrant is difficult to determine at the time of surgery; therefore, the artery must be carefully preserved. The venous drainage system includes the splenic vein and the portal vein. This anatomy is familiar to any surgeon who performs pancreatic surgery.
Variations in the vascular and biliary structures of the liver: a comprehensive anatomical study
Published in Acta Chirurgica Belgica, 2018
Burak Veli Ülger, Eyüp Savaş Hatipoğlu, Özgür Ertuğrul, Mehmet Cudi Tuncer, Cihan Akgül Özmen, Mesut Gül
Liver arterial blood is supplied by the proper hepatic artery, a branch of the common hepatic artery associated (in the hepatoduodenal ligament) with the hepatic portal vein and the bile duct. The proper hepatic artery divides into two branches (left and right) in the porta hepatis. These branches enter the liver along with branches of the hepatic portal veins. This “normal” anatomy is present in only 55–60% of the population [8]. In addition to these arteries, an accessory hepatic artery may be present. As the embryological development of the coeliac trunk and superior mesenteric artery is complex, variations in the proper hepatic artery are common and must be considered when surgery is being planned. Normally, the common hepatic artery originates from the coeliac trunk. However, variations include arteries originating from the superior mesenteric or left gastric arteries. Such arteries are called replaced arteries because they replace the right branch of the proper hepatic artery. They are located near the lateral hepatic portal vein, and posterior to the common hepatic duct, in the hepatoduodenal ligament, and may be damaged if variations are not detected prior to surgery [9]. One of the first studies on arterial variations in the liver was the frequently cited 1966 work of Michels [10] based on a series of 200 autopsies. Eleven liver arterial variations were defined.
Presence of tumor-infiltrating CD8+ T cells and macrophages correlates to longer overall survival in patients undergoing isolated hepatic perfusion for uveal melanoma liver metastasis
Published in OncoImmunology, 2020
Junko Johansson, Jan Siarov, Roberta Kiffin, Johan Mölne, Jan Mattsson, Peter Naredi, Roger Olofsson Bagge, Anna Martner, Per Lindnér
During IHP catheters are inserted into the iliac vein and the axillary vein to allow for shunting of blood from the lower extremity. A catheter is placed in the retrohepatic portion of the caval vein for perfusion outflow and the caval vein is clamped suprahepatic and below the catheter. The portal vein is clamped and the proper hepatic artery is cannulated via the gastroduodenal artery. The catheters are then connected to the perfusion system. When steady-state conditions in the perfusion circuit are established, melphalan (1 mg/kg bodyweight) is added to the perfusion system. The perfusion is performed with a target liver temperature of 40°C. The leakage from the perfusion circuit is continuously recorded. Perfusion is continued for 60 minutes, after which the perfusion is discontinued and the liver is irrigated. The shunts and the perfusion circuit are disconnected and the catheters are removed.
Related Knowledge Centers
- Common Hepatic Artery
- Duodenal Bulb
- Gastroduodenal Artery
- Common Bile Duct
- Liver
- Gallbladder
- Celiac Artery
- Portal Vein
- Lobules of Liver
- Supraduodenal Artery