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Journal articles on the topic 'Aberrant Left Hepatic Artery'

Author: Grafiati

Published: 5 June 2025

Last updated: 24 June 2025

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1

GEORGESCU, Dragos Eugen, Teodor Florin GEORGESCU, Florin Teodor BOBIRCA, Luiza Georgia SERBANESCU, Traian PATRASCU, and Mihai Teodor GEORGESCU. "Preserving Left Aberrant Hepatic Artery During Gastrectomy for Cancer – Literature Review and Case Report." Medicina Moderna - Modern Medicine 30, no. 1 (2023): 69–73. http://dx.doi.org/10.31689/rmm.2023.30.1.69.

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Introduction: Identifying left aberrant hepatic artery during gastrectomy for cancer is occasional. In case of replaced left hepatic artery, its ligation can lead to hepatic injury or ischemia, while preserving it can cause difficulties during lymphadenectomy. In literature there is no consensus regarding preserving replaced left hepatic artery during gastrectomy for cancer. A recent study, analysing adverse effects of ligating an aberrant left hepatic artery, shows in pacients with over 5 times elevated transaminase levels, increase in hospital length and postoperative complications. On the other hand, there are studies that consider ligation of aberrant left hepatic artery safe, the only inconvenient being postoperative transient elevation of transminase levels, when ligated artery diameter is over 1.5 mm. Matherial and methoods: We report the case of a 65 years old male, known with myocardial infarction, admitted for epigastric pain, nausea, vomiting, dysphagia for solids and important weight loss. Upper gastrointesinal endoscopy with biopsy and computed tomography showed eso-gastric tumoral mass, signet ring cell carcinoma, no metastases. Intraopertive, we found replaced left heaptic artery arising from left gastric artery, close to the celiac trunk, its diameter being approximately 1 cm. Total radical D2 gastrectomy with mechanical eso-jejunal Roux-en-Y anastomosis was performed. Postoperative evolution was favourable surgically, but the patient had SarsCov2 infection during hospitalisation The final pathology report showed 18 lymph nodes examined, 5 being with adenocarcinoma metastases. Conclusions: Preserving replaced left hepatic artery during gastectomy for cancer is preferable, lyphadecnectomy not being affected. Potential postoperative complications resulted from ligation of replaced left hepatic artery could have chanced the prognosis.

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2

Du, Dongdong, Zhenhai Zhang, Xinxing Wang, Mingze Ma, and Naishi Wu. "Retrospective Analysis of Aberrant Hepatic Artery in 1250 Patients with Hepatocellular Carcinoma Undergoing Transarterial Chemoembolization." Annali Italiani di Chirurgia 95, no. 3 (2024): 364–73. http://dx.doi.org/10.62713/aic.3366.

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AIM: Aberrant hepatic artery is particularly common, and its diversity and complexity play a critical role in surgery. The aim of this study was to describe the incidence and type of aberrant hepatic artery, and to compare differences in transarterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC) with vs without aberrant hepatic artery. METHODS: This was a retrospective study of patients with HCC who received TACE at the same intervention center between March 15, 2020 and December 31, 2022. All patients who met inclusion criteria were divided into two groups based on whether or not they had aberrant hepatic artery. The aberrant hepatic artery was systematically classified according to variations in origin. We compared differences in baseline characteristics, operation duration, and postoperative hospitalization between the two groups. Postoperative adverse events and laboratory data were also compared. RESULTS: A total of 1250 patients hospitalized with HCC were included in the study (mean age, 58 ± 10 years, 1019 [81.5%] males). A high incidence of aberrant hepatic artery was found during TACE (21.3%, 266 of 1250), mainly involving a single variation of the aberrant left hepatic artery (aLHA) (6.1%, 76 of 1250) or aberrant right hepatic artery (aRHA) (10.9%, 136 of 1250) origin, as well as complex variations of the aLHA and aRHA origin (2.4%, 30 of 1250). When comparing patients with vs without aberrant hepatic artery, the TACE operation duration was significantly different (p < 0.001), and tended to be greater for patients with aberrant hepatic artery. In addition, differences between aberrant and normal hepatic artery groups in postoperative nausea and vomiting were statistically significant (40.2% vs 30.8%, respectively, p = 0.004). Postoperative laboratory examinations revealed significant differences in aspartate aminotransferase, alanine aminotransferase, and neutrophil percentage between the two groups (p < 0.05). CONCLUSIONS: The incidence of aberrant hepatic artery is extremely high, and the condition is characterized by complex variations. Moreover, aberrant hepatic artery may have a critical impact on the course of TACE treatment.

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3

Lynch, J., A. Montgomery, S. Shelmerdine, and J. Taylor. "Ruptured aneurysm of an aberrant left hepatic artery." Case Reports 2013, no. 05 1 (2013): bcr2013201409. http://dx.doi.org/10.1136/bcr-2013-201409.

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4

Nehoda, H., M. Lanthaler, B. Labeck, et al. "Aberrant Left Hepatic Artery in Laparoscopic Gastric Banding." Obesity Surgery 10, no. 6 (2000): 564–68. http://dx.doi.org/10.1381/096089200321594183.

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5

Edoga, John K. "Laparoscopic Fundoplication and the Aberrant Left Hepatic Artery." Archives of Surgery 132, no. 4 (1997): 448. http://dx.doi.org/10.1001/archsurg.1997.01430280122022.

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6

Salve, V. M., and C. Ratanprabha. "Multiple Variations of Branches of Abdominal Aorta." Kathmandu University Medical Journal 9, no. 1 (2012): 72–76. http://dx.doi.org/10.3126/kumj.v9i1.6268.

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The Abdominal aorta and its major branches supply oxygenated blood to nearly all the organs in the abdominal cavity. During routine dissection (January 2009) of a middle aged male cadaver at Dr. PSIMS, Gannavaram, Krishna Dist. (INDIA), the following variations of branches of abdominal aorta were found. The coeliac trunk gave off three branches. The first branch was left inferior phrenic artery which arose directly from coeliac trunk. The second branch bifurcates into left gastric artery and accessory hepatic artery for left lobe of liver. The second branch gave off splenic artery and common hepatic artery. The right testicular artery took its origin from right aberrant renal artery. This variation was associated with the presence of bilateral aberrant renal arteries for lower poles of both kidneys arising from abdominal aorta and aberrant renal arteries bilateral for upper poles originating from the renal arteries. Anatomical variation of testicular arteries is reported to be 4.7 %. Apart from creating hazards during abdominal surgery, vascular variation can also become a technical problem for infusion therapy and chemoembolisation of neoplasm in the liver.http://dx.doi.org/10.3126/kumj.v9i1.6268 Kathmandu Univ Med J 2011;9(1):72-6

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7

Yaseen, Sabah, Surbhi Wadhwa, Kahkashan Jeelani, Anita Mahajan, and Sabita Mishra. "Abnormal Persistence of Embryonic Blood Supply of Liver: Anatomist’s Delight, Surgeon’s Nightmare." Acta Medica (Hradec Kralove, Czech Republic) 62, no. 2 (2019): 72–76. http://dx.doi.org/10.14712/18059694.2019.106.

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The high incidence of hepato-biliary vascular anatomy variations necessitates its evaluation prior to performing liver transplantation, hepatobiliary, pancreatic, gastric and oesophageal surgeries. We report a unique case of persistence of embryonic arteries of the liver, wherein, the liver was supplied by five vessels. In addition to the usual right and left hepatic arteries from the hepatic artery proper, the liver received two accessory right hepatic arteries, one from the gastroduodenal artery, while another arising from superior mesenteric artery and an accessory left hepatic artery, from the left gastric artery. The origin of gastroduodenal artery was found to be unusually high and its abnormal anterior course over the common bile duct further added complexity to the hepatobiliary anatomy. The presence of these aberrant and accessory arteries predisposes to inadvertent injury leading to patient morbidity and sometimes mortality.

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8

Petzold, Sandra, Silke Diana Storsberg, Karin Fischer, and Sven Schumann. "Variant Arterial Supply of the Descending Colon by the Coeliac Trunk: A Case Report." Medicina 57, no. 5 (2021): 487. http://dx.doi.org/10.3390/medicina57050487.

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Background and Objectives: Knowledge of arterial variations of the intestines is of great importance in visceral surgery and interventional radiology. Materials and Methods: An unusual variation in the blood supply of the descending colon was observed in a Caucasian female body donor. Results: In this case, the left colic artery that regularly derives from the inferior mesenteric artery supplying the descending colon was instead a branch of the common hepatic artery. Conclusions: Here, we describe the very rare case of an aberrant left colic artery arising from the common hepatic artery in a dissection study.

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9

An, Chansik, and Joon-Seok Lim. "Aberrant Left Hepatic Artery Arising from Left Gastric Artery at Curative Gastrectomy for Gastric Cancer." Journal of International Society for Simulation Surgery 1, no. 2 (2014): 87–89. http://dx.doi.org/10.18204/jissis.2014.1.2.087.

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10

Ünal, Emre, and Musturay Karcaaltincaba. "Aberrant left gastric vein is associated with hepatic artery variations." Abdominal Radiology 44, no. 9 (2019): 3127–32. http://dx.doi.org/10.1007/s00261-019-02076-2.

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11

Azevedo, Joao Luiz M. C., Otávio Azevedo, Ludmila Kobayashi, Vanessa Paiva, and Fábio Kozu. "Preservation of an Aberrant Left Hepatic Artery During Toupet Fundoplication." Surgical Laparoscopy, Endoscopy & Percutaneous Techniques 14, no. 2 (2004): 105. http://dx.doi.org/10.1097/00129689-200404000-00020.

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12

Maki, Harufumi, Hitoshi Satodate, Shouichi Satou, et al. "Clinical evaluation of the aberrant left hepatic artery arising from the left gastric artery in esophagectomy." Surgical and Radiologic Anatomy 40, no. 7 (2018): 749–56. http://dx.doi.org/10.1007/s00276-018-2022-4.

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13

Puerta, Ana, Marta Cuadrado, José Alberto Vilar, and Pablo Priego. "Laparoscopic D2 lymphadenectomy with preservation of an aberrant left hepatic artery." Cirugía Española (English Edition) 99, no. 7 (2021): 539. http://dx.doi.org/10.1016/j.cireng.2021.06.010.

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14

Civalleri, Dario, Gianni Scopinaro, Gianantonio Simoni, Franco Claudiani, Marina Repetto, and Franco De Cian. "Intrahepatic Arterial flow Distribution after Ligation of A Right Replaced Hepatic Artery. A Case Report." Tumori Journal 71, no. 4 (1985): 375–77. http://dx.doi.org/10.1177/030089168507100410.

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A basic requirement for arterial chemotherapy of liver tumors is complete catheter perfusion of the liver. In cases with atypical anatomy of the hepatic artery, it is frequently impossible to obtain this goal by means of a single catheter. In a patient with a right replaced hepatic artery, the aberrant vessel was ligated and the left hepatic artery was perfused through a catheter inserted into the gastroduodenal artery. Perfusion scans performed through the catheter 14 and 135 days after arterial ligation showed a fall in the arterial flow to the right liver (right/left ratio 0.43 and 0.60). In contrast, a nearly complete perfusion of the liver (0.91 right/left ratio) was obtained 28 days after ligation, when the perfusion scan was performed immediately after catheter infusion of 90,000,000 degradable starch microspheres (DSM: diameter = 40 m). DSM administration is supposed to increase back pressure in the lobe receiving native circulation, thus activating intrahepatic collateral flow to the ischemic lobe. As regards regional treatment of liver tumors, obvious conclusions are to be drawn.

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15

Tao, Wei, Dong Peng, Yu-Xi Cheng, and Wei Zhang. "Clinical significance of aberrant left hepatic artery during gastrectomy: A systematic review." World Journal of Clinical Cases 10, no. 10 (2022): 3121–30. http://dx.doi.org/10.12998/wjcc.v10.i10.3121.

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16

Umugwaneza, Nathalie, Fidele Byiringiro, Paul Ndahimana, et al. "Unusual anatomical variations of the hepatic arteries and bile ducts: What are the surgical implications." African Health Sciences 22, no. 3 (2022): 697–702. http://dx.doi.org/10.4314/ahs.v22i3.74.

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Introduction: The knowledge of anatomy is essential for surgical safety and impacts positively on patients’ outcomes. Surgeons operating on the liver and bile ducts should keep in mind the normal anatomy and its variations as the latter are common. Case Presentation: We conducted a structured surgical dissection course of the supra-colic compartment of the abdominal cavity on 2nd and 3rd October 2020. While dissecting a 46years-old male cadaver, we encountered unusual anatomical variations of the hepatic arterial branching, the biliary tree, and arterial supply to the common bile duct. The common hepatic artery was dividing into two branches: a common short trunk for the left hepatic artery and the right gastric artery (hepato-gastric trunk) and a common trunk for the right hepatic artery and gastroduodenal artery (hepato-gastroduodenal trunk). The right hepaticduct was duplicated with a main right hepatic duct and an additional smaller duct. The bile duct was supplied by an artery coming from the abdominal aorta. Conclusion: We described three unusual anatomical variations: a variation of the hepatic arteries branching pattern, an aberrant right hepatic duct, and blood supply to the bile duct from the abdominal aorta. Surgeons should be aware of these rare variations. Keywords: (MeSH terms); Hepatic artery; Bile duct; variation; Surgical implication.

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17

Shukuzawa, Kota, Naoki Toya, Soichiro Fukushima, Masamichi Momose, Tadashi Akiba, and Takao Ohki. "Surgical Treatment of a Giant Right Hepatic Artery Aneurysm with an Aberrant Left Hepatic Artery: Report of a Case." Annals of Vascular Diseases 8, no. 3 (2015): 271–73. http://dx.doi.org/10.3400/avd.cr.15-00061.

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18

Okano, Shinji, Kiyoshi Sawai, Hiroki Taniguchi, and Toshio Takahashi. "Aberrant left hepatic artery arising from the left gastric artery and liver function after radical gastrectomy for gastric cancer." World Journal of Surgery 17, no. 1 (1993): 70–73. http://dx.doi.org/10.1007/bf01655708.

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19

Montalti, Roberto, Andrea Benedetti Cacciaguerra, Daniele Nicolini, et al. "Impact of aberrant left hepatic artery ligation on the outcome of liver transplantation." Liver Transplantation 24, no. 2 (2018): 204–13. http://dx.doi.org/10.1002/lt.24992.

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20

Milisavljević, M., S. Marinković, D. Radak, M. ĆEtković, G. Vuĉurević, and D. Trifunović. "Duplication of the superior vena cava associated with atrial termination of the left hepatic vein." Phlebology: The Journal of Venous Disease 28, no. 7 (2012): 369–74. http://dx.doi.org/10.1258/phleb.2012.011156.

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Duplication of the superior vena cava (SVC), associated with an aberrant left hepatic vein (LHV), was found in one of the 58 dissected specimens. The right SVC virtually showed a typical appearance. The persistent left SVC, which drained into the right atrium via the enlarged coronary sinus, was formed by the persistence of the left anterior cardinal vein. The LHV opened into the right atrium, due to the persistent left hepatocardiac channel. The left common carotid artery arose from the brachiocephalic trunk as a consequence of a regression of the embryonic aortic sac. The revealed venous and arterial variations seem to be the first reported vascular combination of this type.

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21

Shinohara, T., S. Ohyama, T. Muto, K. Yanaga, and T. Yamaguchi. "The significance of the aberrant left hepatic artery arising from the left gastric artery at curative gastrectomy for gastric cancer." European Journal of Surgical Oncology (EJSO) 33, no. 8 (2007): 967–71. http://dx.doi.org/10.1016/j.ejso.2007.02.030.

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22

Dhakal, Rajendra, Binay Thakir, Shashank Shrestha, et al. "Aberrent hepatic arteries, a rare anatomic variant: case report." Nepalese Journal of Cancer 7, no. 1 (2023): 7–10. http://dx.doi.org/10.3126/njc.v7i1.59995.

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Anatomic variations of hepatic arteries are observed in 12-49% cases. But replaced right and left hepatic arteries are extremely rare (0.8%). We report a 61 years old male patient with the diagnosis of gastric cancer. He underwent distal subtotal gastrectomy with D2 lymphadenectomy. Intraoperatively, both right and left hepatic arteries were replaced and were arising from superior mesenteric artery and aorta, respectively.

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23

Douard, Richard, Jean-Marc Chevallier, Vincent Delmas, and Paul-Henri Cugnenc. "Laparoscopic detection of aberrant left hepatic artery: a prospective study in 300 consecutive patients." Surgical and Radiologic Anatomy 28, no. 1 (2005): 13–17. http://dx.doi.org/10.1007/s00276-005-0008-5.

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Uraoka, Mio, Naotake Funamizu, Kyosei Sogabe, et al. "Novel embryological classifications of hepatic arteries based on the relationship between aberrant right hepatic arteries and the middle hepatic artery: A retrospective study of contrast-enhanced computed tomography images." PLOS ONE 19, no. 2 (2024): e0299263. http://dx.doi.org/10.1371/journal.pone.0299263.

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Background Variations in hepatic arteries are frequently encountered during pancreatoduodenecomy. Identifying anomalies, especially the problematic aberrant right hepatic artery (aRHA), is crucial to preventing vascular-related complications. In cases where the middle hepatic artery (MHA) branches from aRHAs, their injury may lead to severe liver ischemia. Nevertheless, there has been little information on whether MHA branches from aRHAs. This study aimed to investigate the relationship between aRHAs and the MHA based on the embryological development of visceral arteries. Methods This retrospective study analyzed contrast-enhanced computed tomography images of 759 patients who underwent hepatobiliary-pancreatic surgery between January 2011 and August 2022. The origin of RHAs and MHA courses were determined using three-dimensional reconstruction. All cases of aRHAs were categorized into those with or without replacement of the left hepatic artery (LHA). Results Among the 759 patients, 163 (21.4%) had aRHAs. Five aRHAs patterns were identified: (Type 1) RHA from the gastroduodenal artery (2.7%), (Type 2) RHA from the superior mesenteric artery (SMA) (12.7%), (Type 3) RHA from the celiac axis (2.1%), (Type 4) common hepatic artery (CHA) from the SMA (3.5%), and (Type 5) separate branching of RHA and LHA from the CHA (0.26%). The MHA did not originate from aRHAs in Types 1–3, whereas in Type 4, it branched from either the RHA or LHA. Conclusions Based on the developmental process of hepatic and visceral arteries, branching of the MHA from aRHAs is considered rare. However, preoperative recognition and intraoperative anatomical assessment of aRHAs is essential to avoid injury.

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Besedin, B. V., K. Sh Gantsev, D. T. Arybzhanov, and A. U. Kaskabayev. "Peculiarities of Extra-Organic Variant Anatomy of the Celiac Trunk and Hepatic Artery in Patients with Liver Cancer." Creative surgery and oncology 8, no. 2 (2018): 19–26. http://dx.doi.org/10.24060/2076-3093-2018-8-2-19-26.

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Introduction. Knowledge of the different variants of the structure of the celiac trunk and the hepatic artery is of great importance in the planning, treatment and choice of approaches for transcatheter vascular interventions.Objective: to study features of variant hematopoietic anatomy from direct and multispiral computed tomography angiography (MSCTA) data in order to determine its significance in routine clinical practice.Materials and methods. We analysed the most common variants of branching of the celiac trunk and anatomy of the hepatic artery according to direct angiography and MSCTA data in 112 patients with primary liver cancer. The sample comprised 71 men (63.3 %) and 41 women (36.7 %).Results and discussion. It was found that the most frequent aberration was the passage of the replacement right hepatic artery from the superior mesenteric artery — type 3 according to N. Michels. The second aberration in terms of frequency was Michels type 2. We describe two unusual celiac trunk and hepatic anatomy variants: the first of these comprising a celiac trunk 22 cm long extending from the superior mesenteric artery; the second consisting in a complete absence of the celiac trunk, with all its elements (left gastric artery, common hepatic artery and splenic artery) departing independently from the abdominal aorta.Conclusions. A typical anatomy of the celiac trunk and hepatic artery was found in 60 % of cases, the most frequent aberration being the Michels type 3, noted in 14.2 % of patients, and type 2 noted in 9.8 % of patients. Knowledge of individual blood supply features largely determines the procedure for conducting operations, permitting purposeful intraoperative revision and the selection of the optimal vascular reconstruction variant, and avoiding damage to aberrant arteries.

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Lukashenko, A., N. Kameyama, O. Kolesnik, and V. Zvirich. "617. Preservation of an aberrant hepatic artery arising from the left gastric artery during gastrectomy for gastric cancer." European Journal of Surgical Oncology (EJSO) 42, no. 9 (2016): S184. http://dx.doi.org/10.1016/j.ejso.2016.06.337.

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27

Oki, Eiji, Yoshihisa Sakaguchi, Shoji Hiroshige, Testuya Kusumoto, Yoshihiro Kakeji, and Yoshihiko Maehara. "Preservation of an Aberrant Hepatic Artery Arising from the Left Gastric Artery during Laparoscopic Gastrectomy for Gastric Cancer." Journal of the American College of Surgeons 212, no. 5 (2011): e25-e27. http://dx.doi.org/10.1016/j.jamcollsurg.2011.01.009.

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28

Kim, Jieun, Su Mi Kim, Jeong Eun Seo, et al. "Should an Aberrant Left Hepatic Artery Arising from the Left Gastric Artery Be Preserved during Laparoscopic Gastrectomy for Early Gastric Cancer Treatment?" Journal of Gastric Cancer 16, no. 2 (2016): 72. http://dx.doi.org/10.5230/jgc.2016.16.2.72.

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Fanous, Medhat Y. "Benefit of Laparoendoscopic Repair of Hiatal Hernia in the Presence of Aberrant Left Hepatic Artery." JSLS : Journal of the Society of Laparoendoscopic Surgeons 23, no. 1 (2019): e2019.00004. http://dx.doi.org/10.4293/jsls.2019.00004.

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30

Kuwada, Kazuya, Shinji Kuroda, Satoru Kikuchi, et al. "Strategic approach to concurrent aberrant left gastric vein and aberrant left hepatic artery in laparoscopic distal gastrectomy for early gastric cancer: A case report." Asian Journal of Endoscopic Surgery 8, no. 4 (2015): 454–56. http://dx.doi.org/10.1111/ases.12203.

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Benhima, A., M. Mekouar, Y. El Badri, B. Boutakioute, M. Ouali Idrissi, and N. Cherif Idrissi Gannouni. "A Case Report on an Aortic Root Pseudoaneurysm, a Rare Complication of Infective Endocarditis Revealing a Multitude of Aortic Arch Anomalies Including an Aortic Coarctation in a 20 Year Old Patient." SAS Journal of Medicine 9, no. 06 (2023): 716–19. http://dx.doi.org/10.36347/sasjm.2023.v09i06.032.

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We describe a rare combination of aortic arch variant anatomy, seen on trans-thoracic echocardiogram and cardiac CT during the course of investigations for a suspected aortic dissection in a 20-year-old patient with a history of infective endocarditis. This combination included a truncus bicaroticus, an aberrant right subclavian artery, an aortic coarctation, and a bicuspid aortic valve. This patient also presented a rare complication of infective endocarditis namely a pseudoaneurysm of the Valsalva sinus and some abdominal aortic branch variations. These included a right hepatic artery emanating from the superior mesenteric artery, and a left gastric artery emerging directly from the abdominal aorta adjacent to the coeliac trunk. In isolation, these anomalies have been reported with different frequencies, but as far as we know, this particular combination has rarely been reported. We provide an imagistic portrayal of these anomalies on Tran’s thoracic echocardiogram and cardiac CT.

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Sul, Young Hoon, and Yook Kim. "Management for traumatic hepatic injury diagnosed by contrast-enhanced ultrasonography in a patient with an occluded coeliac axis: a case report." Journal of International Medical Research 49, no. 6 (2021): 030006052110199. http://dx.doi.org/10.1177/03000605211019926.

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Transcatheter arterial embolization (TAE) is the standard of care for haemodynamically-stable patients with blunt hepatic injury but it is sometimes impossible due to unfavourable vascular anatomies. This case report describes a 43-year-old male patient with abdominal pain following a motorcycle accident. Based on computed tomography (CT) findings, he was diagnosed with high-grade hepatic injury with coeliac axis stenosis (CAS) due to compression by the median arcuate ligament, and an aberrant right hepatic artery. Contrast-enhanced ultrasonography (CEUS) demonstrated multiple high echogenic tubular and ovoid structures suggestive of active bleeding within the injured liver area. Angiography revealed unique interlobar and intrahepatic collateral vessels between the right and left hepatic arteries. Liver haemorrhages were also identified. Catheterization of the feeding arteries through the collateral pathway was unsuccessful, so a decision was made to cannulate the stenotic portion of the coeliac trunk with a 5-Fr Yashiro catheter. After several attempts, the microcatheter was successfully advanced coaxially into the common hepatic artery. Embolization was performed with a 1:2 mixture of N-butyl cyanoacrylate and iodized oil. Successful haemostasis was confirmed following TAE. CEUS helped clinicians identify active bleeding following traumatic solid organ injury. TAE was a safe and effective treatment strategy. Before performing TAE, attention should be given to the presence of CAS associated with compression by the median arcuate ligament.

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Langman, Gerald, Helen Wainwright, and Louise Matthews. "Absence of the Ductus Venosus with Direct Connection between the Umbilical Vein and Right Atrium." Pediatric and Developmental Pathology 4, no. 3 (2001): 298–303. http://dx.doi.org/10.1007/s100240010172.

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Abnormalities of the ductus venosus are rare. We present the case of a dichorionic, diamniotic twin pregnancy in which complete absence of the ductus venosus, with direct communication between the umbilical vein and right atrium, was detected in one infant on antenatal ultrasonography. Autopsy confirmed the aberrant course of the umbilical vein, which also had an abnormal histological structure. Associated congenital anomalies included an ostium secundum type atrial septal defect, absent inferior vena cava, single left pulmonary vein, stenosed right pulmonary artery, proliferation of the hepatic arterioles with reduction of portal venules, and a duplex ureter. The literature is reviewed and pathogenesis relevant to this case is discussed.

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Fanous, Medhat, Wei Wei, Anja Jaehne, and David Lorenson. "Laparoscopic Repair of Hiatal Hernia in the Presence of Aberrant Left Hepatic Artery Using Extracorporeal Sliding Arthroscopic Knots." American Surgeon 84, no. 7 (2018): 251–53. http://dx.doi.org/10.1177/000313481808400716.

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35

Lee, Sejin, Taeil Son, Jeong Ho Song, et al. "Adverse Effects of Ligation of an Aberrant Left Hepatic Artery Arising from the Left Gastric Artery during Radical Gastrectomy for Gastric Cancer: a Propensity Score Matching Analysis." Journal of Gastric Cancer 21, no. 1 (2021): 74. http://dx.doi.org/10.5230/jgc.2021.21.e6.

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36

Kim, Sa-Hong, Franco José Signorini, Kyoyoung Park, et al. "Alterations in portal vein confluence during gastric cancer surgery: two case reports." Korean Journal of Clinical Oncology 21, no. 1 (2025): 40–46. https://doi.org/10.14216/kjco.24329.

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This article presents two cases of extrahepatic portal vein anomalies that can be challenging during lymph node (LN) dissection in gastric cancer surgery. The first case was a participant for a clinical trial assessing the completeness of D2 LN dissection. The trial utilized near-infrared (NIR) lymphangiography with indocyanine green only after completing dissection of a certain topological LN station to detect any residual lymphatic tissue. However, the patient was excluded from the trial due to an unexpected extrahepatic portal vein confluence anomaly and aberrant common hepatic artery. Consequently, continuous lymphatic navigation with NIR imaging was utilized for remaining surgery. The second case featured a patient with an anteriorly positioned splenic vein, hindering LN dissection along the left gastric artery. Preoperative identification of great vessel anomalies around the stomach is critical to prevent life-threatening complications during LN dissection in gastric cancer surgery. Augmented imaging technology can be a valuable tool in ensuring oncologic safety and precision.

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Sürgit, Önder. "Totally Laparoscopic Subtotal Gastrectomy (D2+) with Jejunal Roux-en-Y Reconstruction and Aberrant Left Hepatic Artery: A Case Report." Meandros Medical and Dental Journal 17, no. 3 (2016): 157–62. http://dx.doi.org/10.4274/meandros.1908.

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Hasheem, Jisha Sree, and Rohini Avantsa. "A Case Report of Hepato Spleno Mesenteric Trunk – A Rare Vascular Variation." Journal of Evolution of Medical and Dental Sciences 10, no. 29 (2021): 2217–20. http://dx.doi.org/10.14260/jemds/2021/453.

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Major sources of the vascular supply of the gastrointestinal tract are the celiac trunk (CT) and superior mesenteric artery (SMA) which are the main proximal branches of the abdominal aorta. The CT gives rise to three branches normally as follows: left gastric artery (LGA), common hepatic artery (CHA) and splenic artery (SA). The branching pattern of the CT is considered as the most literature explained anatomical pattern.1 After the CT, the abdominal aorta gives the second named branch as superior mesenteric artery. Vascular variations of the celiac trunk and superior mesenteric artery are common and had been described earlier.2 These variations are caused due to the aberrant embryological development of splanchnic arteries. The incidence of hepato-spleno-mesenteric trunk has been reported by various authors as 0.68 %,3 0.7 %,4 0.3 %,5 0.4 %,6 or 1 %.7 The importance of knowledge of these variations lies in preplanning of invasive surgical techniques, organ transplantation, diagnosis, prevention, and management of some metastatic tumours and to overcome the catastrophic consequences like bowel ischemia due to common trunk.8 Hence a better understanding of these anatomical variations is considered vital for surgeons or radiologists for appropriate planning and conduction of surgical procedures or interventions.9 Most of the anatomical variations in abdominal aorta branches are asymptomatic and incidental findings while imaging for other aetiologies. But the identification of such vascular variations is of utmost importance in clinical practice. The Hepatospleno-mesenteric trunk [HSMT] is one of those variations and was less frequently reported. The authors describe a case report of the hepato-spleno-mesenteric trunk which was incidentally detected in the multi detector computed tomography study of the abdomen of a 54-year-old male patient who had been diagnosed to have chronic liver disease and hepatic encephalopathy. The origin of the HSMT [with a diameter of 11mm] occurs from the abdominal aorta at the level of the L2 vertebral body and is divided into the hepatosplenic trunk [diameter of 7 mm] and superior mesenteric artery [diameter of 7.5 mm] after coursing for a length of 28 mm. The hepatosplenic trunk ascends superiorly for a length of 20 mm and divided into two terminal branches: common hepatic (6 mm) and splenic artery (6 mm).

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Bexheti, Ema, Emilija Novaković, Zdravko Vitošević, and Milan Milisavljević. "Coronary sinus, microanatomical study." Praxis medica 51, no. 3-4 (2022): 13–18. http://dx.doi.org/10.5937/pramed2204013b.

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INTRODUCTION: Complete appreciation of the cardiac venous system requires an understanding of its embryological basis, its usual patterns of distribution, and its common variations. AIM: The aim of our study was to improve our understanding of the coronary sinus morphometrical and topographical anatomy. METHODS: The investigations were carried out on 25 human hearts (from 11 male and 14 female persons of mean age 59.5; range: 40 to 75 years). The classic anatomical technique of microdissection (using neurosurgical microinstruments) was performed under the stereoscopic microscope on 10 specimens injected with a 10% formaldehyde solution. The arteries and veins of an additional 15 hearts were injected with methylmethacrylate and immersed in a 40% solution of NaOH for corrosion. Following washing out and drying, the obtained vascular casts were examined and measured. RESULTS: Coronary sinus (CS) extends from the opening of the oblique vein of the left atrium into the great cardiac vein, to its empty orifice into the right atrium. The length of CS varied between 22.4 and 41.4 mm (mean 33.0 ± 6.1 mm). The diameter of CS at its beginning was 5.0 - 9.6 mm (mean 6.6 ± 1.3 mm), and its diameter at its atrial mouth varied from 6.6 - 12.0 mm (mean 8.4 ± 1.6 mm). The CS had varied relationships to the branches of the left or right coronary arteries. It extended superficial and above the artery in 16 (64%) hearts, and close superficial to the artery in 9 (36%) cases. Duplication of the superior vena cava associated with an aberrant left hepatic vein was found in one case. The persistent left superior vena cava, which drained into the right atrium via the enlarged coronary sinus, was formed by the persistence of the left anterior cardinal vein. CONCLUSION: Our study shows that the coronary sinus, created in an early stage of embryological development, is an important collecting vessel receiving the main veins of the heart.

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Stern, Jordan R., Adham Elmously, Matthew C. Smith, et al. "Transradial interventions in contemporary vascular surgery practice." Vascular 27, no. 1 (2018): 110–16. http://dx.doi.org/10.1177/1708538118797556.

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Objectives Upper extremity arterial access is often required for endovascular procedures, especially for antegrade access to the visceral aortic branches. Radial arterial access has been shown previously to have low complication rates, and patients tolerate the procedure well and are able to recover quickly. However, transradial access remains relatively uncommon amongst vascular surgeons. Methods The radial artery was evaluated by ultrasound to evaluate for adequate caliber, and to identify any aberrant anatomy or arterial loops. A modified Barbeau test was performed to ensure sufficient collateral circulation. A cocktail of nitroglycerin, verapamil and heparin was administered intra-arterially to combat vasospasm. Sheaths up to 6 French were utilized for interventions. On completion of the procedure, a compression band was used for hemostasis in all cases. Results Twenty-five interventions were performed in 24 patients. The left radial artery was used in 23/25 cases (92.0%). Procedures included visceral and renal artery interventions; stent graft repair of a renal artery aneurysm; embolization of splenic, pancreaticoduodenal and internal mammary aneurysms; embolization of bilateral hypogastric arteries following blunt pelvic trauma; interventions for peripheral arterial disease; delivery of a renal snorkel graft during endovascular aortic aneurysm repair, and access for diagnostic catheters during thoracic endovascular aortic aneurysm repair. Technical success was 92.0%. There was one post-operative radial artery occlusion (4.3%) which led to paresthesias but resolved with anticoagulation. There were no instances of arterial rupture, hematoma, or hand ischemia requiring intervention. Conclusions Using the transradial approach, we have demonstrated a high technical success rate over a range of clinical contexts with minimal morbidity and no significant complications such as bleeding or hand ischemia. The safety profile compares favorably to historical complication rates from brachial access. Radial access is a safe and useful skill for vascular surgeons to master.

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Dandekar, Usha, Kundankumar Dandekar, and Sushama Chavan. "Right Hepatic Artery: A Cadaver Investigation and Its Clinical Significance." Anatomy Research International 2015 (December 16, 2015): 1–6. http://dx.doi.org/10.1155/2015/412595.

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The right hepatic artery is an end artery and contributes sole arterial supply to right lobe of the liver. Misinterpretation of normal anatomy and anatomical variations of the right hepatic artery contribute to the major intraoperative mishaps and complications in hepatobiliary surgery. The frequency of inadvertent or iatrogenic hepatobiliary vascular injury rises with the event of an aberrant anatomy. This descriptive study was carried out to document the normal anatomy and different variations of right hepatic artery to contribute to existing knowledge of right hepatic artery to improve surgical safety. This study conducted on 60 cadavers revealed aberrant replaced right hepatic artery in 18.3% and aberrant accessory right hepatic artery in 3.4%. Considering the course, the right hepatic artery ran outside Calot’s triangle in 5% of cases and caterpillar hump right hepatic artery was seen in 13.3% of cases. The right hepatic artery (normal and aberrant) crossed anteriorly to the common hepatic duct in 8.3% and posteriorly to it in 71.6%. It has posterior relations with the common bile duct in 16.7% while in 3.4% it did not cross the common hepatic duct or common bile duct. The knowledge of such anomalies is important since their awareness will decrease morbidity and help to keep away from a number of surgical complications.

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Kirsch, Jacobo, and Eric E. Williamson. "Aberrant left internal mammary artery off an aberrant vertebral artery." European Heart Journal 29, no. 14 (2008): 1782. http://dx.doi.org/10.1093/eurheartj/ehn039.

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Tzimas, George N., Jeffrey S. T. Barkun, Peter Metrakos, and Jean I. Tchervenkov. "Aberrant right hepatic artery: A mockery." Liver Transplantation 8, no. 4 (2002): 411. http://dx.doi.org/10.1053/jlts.2002.32939.

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Tzimas, George N., Jeffrey S. T. Barkun, Peter Metrakos, and Jean I. Tchervenkov. "Aberrant right hepatic artery: A mockery." Liver Transplantation 8, no. 4 (2003): 411. http://dx.doi.org/10.1002/lt.500080417.

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SANAL, İbrahim, Necdet AYBASTI, Hayri ERKOL, Avni GÖKALP, and Oral KILINÇ. "A Variant Case of Right Aberrant Hepatic Artery." European Journal of Therapeutics 2, no. 2 (1991): 222–26. http://dx.doi.org/10.58600/eurjther.19910202-551.

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A case of right aberrant hepatic artery with unusual localisation was presented. The anomalous artery compressed gallbladder and both this aberrant artery and gallstone probably led to hydrops formation by 'Ball Valve' mechanism.

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Pai, R. Shakuntala, A. Shahin Hunnargi, and Mamata Srinivasan. "Accessory left hepatic artery arising from common hepatic artery." Indian Journal of Surgery 70, no. 2 (2008): 80–82. http://dx.doi.org/10.1007/s12262-008-0021-0.

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Troutman, Douglas A., Griffin K. Bicking, Nicholas J. Madden, and Gregory S. Domer. "Aberrant origin of left vertebral artery." Journal of Vascular Surgery 58, no. 6 (2013): 1670. http://dx.doi.org/10.1016/j.jvs.2012.08.101.

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Gunwant, Dr Chaudhari, Dr Sonawane Monali, Dr Singel T.C, and Dr Chaudhari Heena. "Aberrant Right Hepatic Artery: A Systematic Review." Scholars International Journal of Anatomy and Physiology 3, no. 9 (2020): 86–89. http://dx.doi.org/10.36348/sijap.2020.v03i09.001.

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Yang, Feng, Jiang Long, De-Liang Fu, et al. "Aberrant Hepatic Artery in Patients Undergoing Pancreaticoduodenectomy." Pancreatology 8, no. 1 (2008): 50–54. http://dx.doi.org/10.1159/000114867.

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Oswal, Nilesh, Georgi Christov, Shankar Sridharan, Sachin Khambadkone, Catherine Bull, and Ian Sullivan. "Aberrant subclavian artery origin in tetralogy of Fallot with pulmonary stenosis is associated with chromosomal or genetic abnormality." Cardiology in the Young 24, no. 3 (2013): 478–84. http://dx.doi.org/10.1017/s1047951113000644.

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AbstractWe determined the relationship between aortic arch anatomy in tetralogy of Fallot with pulmonary stenosis and chromosomal or genetic abnormality, by performing analysis of 257 consecutive patients undergoing surgical repair from January, 2003 to March, 2011. Chromosomal or genetic abnormality was identified in 49 of the 257 (19%) patients. These included trisomy 21 (n = 14); chromosome 22q11.2 deletion (n = 16); other chromosomal abnormalities (n = 9); CHARGE (n = 2); Pierre Robin (n = 2); and Kabuki, Alagille, Holt–Oram, Kaufman McKusick, Goldenhar, and PHACE (n = 1 each). Aortic anatomy was classified as left arch with normal branching, right arch with mirror image branching, left arch with aberrant right subclavian artery, or right arch with aberrant left subclavian artery. Associated syndromes occurred in 33 of 203 (16%) patients with left arch and normal branching (odds ratio 1); three of 36 (8%) patients with right arch and mirror image branching (odds ratio 0.4, 95% confidence interval 0.1–1.6); seven of eight (88%) patients with left arch and aberrant right subclavian artery (odds ratio 36, 95% confidence interval 4–302); and six of 10 (60%) patients with right arch and aberrant left subclavian artery (odds ratio 8, 95% confidence interval 2–26). Syndromes were present in 13 of 18 (72%) patients with either right or left aberrant subclavian artery (odds ratio 15, 95% confidence interval 4–45). Syndromes in patients with an aberrant subclavian artery included trisomy 21 (n = 4); chromosome 22q11.2 deletion (n = 5); and Holt–Oram, PHACE, CHARGE, and chromosome 18p deletion (n = 1 each). Aberrant right or left subclavian artery in tetralogy of Fallot with pulmonary stenosis is associated with an increased incidence of chromosomal or genetic abnormality, whereas right aortic arch with mirror image branching is not. The assessment of aortic arch anatomy at prenatal diagnosis can assist counselling.

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