Angiographic findings of extrahepatic branches originating from hepatic artery and its clinical significance

Objective: To observe the presentation and variation of extrahepatic branches originating from hepatic artery by hepatic arteriography.Methods: Hepatic arteriogram of 200 cases with unresectable hepatic primary or metastatic tumors before interventional therapy were retrospectively analyzed. Two interventional radiologists independently reviewed the type, originating artery, distribution and variation of extrahepatic artery.Results: Five types of extrahepatic artery were found, with the most common type of the right gastric artery (n=156, 78%), followed by the cystic artery (n=126, 63%), accessory left gastric artery (n=19, 9.5%), hepatic falciform artery (n=5, 2.5%), and accessory left inferior phrenic artery (n=4, 2%). In 188 cases, there were extrahepatic arteries derived from hepatic proper artery or its branches, and the most frequent originating site was the right hepatic artery (130 extrahepatic branches), followed by the proper hepatic artery (103 branches), left hepatic artery (56 branches) and middle hepatic artery (3 branches). The left hepatic artery was the arising site with the multiple types of extrahepatic branches including all above branches except the cystic artery.Conclusion: Many types of extrahepatic branches usually derive from the hepatic artery or its distal branches, and its originating sites are not constant. It is important to avoid damage of extrahepatic tissue during interventional therapy for liver tumors.