HEPATIC ARTERIAL ANATOMY VARIATIONS IN PATIENTS WITH HEPATOCELLULAR CARCINOMA EVALUATED BY COMPUTED TOMOGRAPHY ANGIOGRAPHY.

Hepatocellular carcinoma (HCC) is the most common primary liver malignancy and one of the major reasons for performing percutaneous endovascular procedures or liver surgery. Hepatic arterial anatomy is of major importance in performing these procedures on the liver. The aim of our study was to estimate the prevalence of various hepatic arterial variants in HCC patients. 78 patients were included in the study. Abdominal multiphase Computed Tomography scans of all patients have been assessed for presence of the hepatic arterial supply anatomical variations. Prevalent variant of arterial anatomy in each group and subgroup has been determined. Standard anatomy was seen in 38 patients. The rest 40 patients had anatomical variations. Among those 7 patients had left hepatic artery (LHA) replaced to the left gastric artery (LGA). 14 patients were found to have replaced right hepatic artery (RHA) from the superior mesenteric artery (SMA). Replaced LHA and RHA were found in 1 patient. Accessory LHA originating from the left gastric artery was found in 5 patients. Accessory RHA arising from the SMA was seen in 5 patients. Simultaneous existence of the replaced RHA and accessory LHA was encountered in 6 cases. Preoperative knowledge of the range of hepatic arterial anomalies and their specific frequencies is of great importance in planning and performance of endovascular interventional procedures. High prevalence of the hepatic arterial anatomy variations favors performing pre-embolization and pre-surgical CTA for the mapping of the hepatic arteries and is in consensus with other authors.