Chemoembolization of hepatocellular carcinoma through an accessory right hepatic artery
Presentation
Female with a history of hepatocellular carcinoma scheduled for chemoembolization where an MRI was performed showing an anatomical variant of the accessory right hepatic artery.
Patient Data
The celiac trunk arises at the level of the abdominal aorta. Immediately adjacent, on the right, is a discreet artery directed towards the hepatic hilum.
In segment VI, a rounded, partially defined hypoenhancing mass is in keeping with the patient's known hepatocellular carcinoma.
The abdominal aorta is observed showing the emergence of two vessels heading towards the hepatic hilum, likewise, the celiac trunk is visualized with the origin of the common hepatic artery, splenic artery and left gastric artery. Noted is an accessory hepatic artery arising from the abdominal aorta where it shows mild enhancement of the segment VI liver lesion. Chemoembolization is performed where it is subsequently performed test observing the absence of hepatic lesion flow.
Case Discussion
Arterial variations commonly include the identification of a hepatic artery left accessory that originates from the gastric artery left in 3% of cases and an accessory hepatic artery right that originates from the mesenteric artery in 11.9% of cases. Additionally, in 1.4% of cases, there were abnormalities in both the left and right hepatic arteries.
Variations of the celiac trunk also occur, with 4.1% of cases having double hepatic arteries that originate from the celiac trunk or directly from the aorta. Atypical branches of the hepatic arteries left and right occur in 0.5% of cases.
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