Angiographic Study Of The Communicating Arteries Between The Liver And The Stomach, The Duodenum And The Pancreas And Their Significance In Interventional Radiology

Purpose: To investigate the anatomic characteristics of the communicating arteries beween the liver and the gastroduodenal tract and the pancreas, in order to improve understanding of such vessels in interpreting angiograms, moreover, to discuss their significance in the related fields of interventional radiology.Materials and Methods1.Subjects: 1000 cases of selective hepatic arteriographies, of which the superior mesenteric arteriography was undergone at the same time in 116 cases, taken randomly from the angiographic archives of the Department of Radiology of General Military Hospital performed from 1986 to 2000, were retrospectively studied.2.Angiogram and Data Analysis:Every piece of angiogram of all cases' was independently reviewed by three experienced interventional radiologists, and a consensus was reached in each of the 1000 cases. The incidence of each of all kinds of communicating arteries was calculated, and its anatomic characteristics such as origin, course, branches and distributing were described as well.3.The nomenclature and classification of the communicating arteries(1) Hepatogastric artery(HGA):A\\ the gastroduodenal arteries that arise from the proper hepatic artery (PHA) or from all levels of intrahepatic arteries distal to the PHA were called hepatogastric arteries (HGAs). Furthermore, according to their different courses and distributions, referring to the normal gastroduodenal arterial anatomy, HGAs were subdivided into right gastric artery (RGA), aberrant left gastric artery (AbLGA), aberrant gastroduodenal artery (AbGDA), aberrant right gastroepiploic artery (AbRGEA), superior duodenal artery (SDA) and other HGA hard to be named.(2)Hepatopancreatic artery(HPA):M\ the aberrant pancreatic arteries that originate from the proper hepatic aretery(PHA) and all the intrahepatic arteries distal to the PHA were called hepatopancreatic arteries(HPAs). Furthermore, according to their different courses and distributing to the pancreas, referring to the normal pancreatic arterial anatomy, HPAs were classified as transverse pancreatic artery(TPA) , superior pancteaticoduodenal artery(SPDA) and other HPA hard to be named. (3)Gastrohepatic artery(GHA):A\\ the aberrant hepatic arteries that originate directly from the celiac axis or from the gastrointestinal arteries were called GHA. According to their different courses and distributing within the liver, GHAs were subdivided into aberrant right hepatic artery(AbRHA), aberrant left hepatic artery(AbLHA), aberrant middle hepatic artery(AbMHA), aberrant proper hepatic artery(AbPHA) and aberrant common hepatic artery(AbCHA). 4, To investigate the influence of the HGA upon the gastrointestinalcomplications in patients with hepatoma after treatment with transcatheter arterial chemoembolization(TACE)(1}Subjects and Grouping:40 cases with the HGA selected at random from those with hepatoma treated with TACE were regarded as the study group.Correspondingly,another 40 patients without the HGA composed the control group. 34 patients had the complete data records in the study group while 32 patients did in the control group.Each patient had at least undertaken one time of TACE.The study group received 42 times of TACE, and control group received 56 times of TACE. In the study group, the superselective catheterization was made and the tip of catheter was kept away from orifice of the HGA before infusion of embolic agents(Lipiodol) during TACE in 18 times, which was called the relative safety group, whereas, that the tip of catheter was not laid distal to orifice of HGA in 24 times was called the dangerous group.(2}Grading the gastrointestinal complications:Based upon the seriousness, the patients'gastrointestinal side-effects of TACE were divided into the normal, the mild and the severe response grade.(1)Statistical analysis:The incidence of gastrointestinal response in diferent group was respectively calculated. The statistical difference between the groups was determined by using the Fisher exact test. The level of sign...