Shallu Garg1, K Hemanth Kumar1, Daisy Sahni1, Thakur Deen Yadav1, Anjali Aggarwal2, Tulika Gupta1. 1. Post Graduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India. 2. Post Graduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India. Electronic address: anjali.agg52@gmail.com.
Abstract
BACKGROUND: To describe the hepatic arterial anatomy in detail, tracing the individual hepatic arteries from their origin, extrahepatic course, branching to their segmental territorial supply as applicable to the vascular mapping for hepatic endovascular procedures. METHODS: The study was conducted on 100 formalin fixed adult cadaveric livers. The hepatic arterial anatomy was dissected from the origin of hepatic arteries up to their segmental branching. RESULTS: The origin of hepatic arteries was standard in 72% and aberrant in 28% livers. In livers with standard origin, extrahepatic branching of the main hepatic artery was close to the hepatic hilum in 48% and was in the lower part of the hepatoduodenal ligament in 24% livers. The pattern of extrahepatic branching in each type was three and five respectively. Aberrant arterial anatomy was broadly categorized into three groups. The mapping of segmental arterial vascularization of individual hepatic arteries in each type was also done. CONCLUSIONS: In the present study, an attempt was made to systematically describe the complex hepatic arterial anatomy in a clinically applicable fashion. High variability was seen in the hepatic arterial anatomy at each level, a lot of which could not be included in the current classification systems. The information provided is an important prerequisite for performing accurate intra-arterial hepatic interventions.
BACKGROUND: To describe the hepatic arterial anatomy in detail, tracing the individual hepatic arteries from their origin, extrahepatic course, branching to their segmental territorial supply as applicable to the vascular mapping for hepatic endovascular procedures. METHODS: The study was conducted on 100 formalin fixed adult cadaveric livers. The hepatic arterial anatomy was dissected from the origin of hepatic arteries up to their segmental branching. RESULTS: The origin of hepatic arteries was standard in 72% and aberrant in 28% livers. In livers with standard origin, extrahepatic branching of the main hepatic artery was close to the hepatic hilum in 48% and was in the lower part of the hepatoduodenal ligament in 24% livers. The pattern of extrahepatic branching in each type was three and five respectively. Aberrant arterial anatomy was broadly categorized into three groups. The mapping of segmental arterial vascularization of individual hepatic arteries in each type was also done. CONCLUSIONS: In the present study, an attempt was made to systematically describe the complex hepatic arterial anatomy in a clinically applicable fashion. High variability was seen in the hepatic arterial anatomy at each level, a lot of which could not be included in the current classification systems. The information provided is an important prerequisite for performing accurate intra-arterial hepatic interventions.