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The falciform artery, also known as the hepatic falciform artery (HFA) is an uncommon vascular anatomic variant that most commonly arises as the terminal branch of the middle hepatic artery which courses anteriorly through the falciform ligament into and supplying the supraumbilical anterior abdominal wall. It less commonly arises from the left hepatic artery or right hepatic artery. It may have anastomoses with terminal branches of the internal thoracic artery and superior epigastric artery.
It has a wide reported prevalence of as low as 2% in a small angiographic cohort (n=25) 1 to 52% in a much bigger angiographic study (n=250) 3, but both these studies were in patients with hepatocellular carcinoma (HCC).
It is clinically important to recognize during angiographic workup for patients with HCC prior to transcatheter arterial chemoembolication (TACE) as inadvertent chemoembolisation of the artery can lead to necrosis of the anterior abdominal wall.
Rare occurrence of iatrogenic falciform artery injury could be due to omentectomy during laparoscopic tenchkoff insertion.