Hepatic falciform artery. Angiographic findings in 25 patients.
OBJECTIVE
To determine the frequency of hepatic falciform artery (HFA) occurrence on celiac or hepatic angiograms and elucidate the anatomy and clinical importance.


METHODS
Among 1,250 patients who underwent celiac or hepatic arteriography, we encountered 25 patients (2%) with a HFA. Prospectively, CT hepatic falciform arteriography (CTHA) was performed in 4 patients. Indigocarmine dye was injected into the HFA in 6 patients to evaluate whether the abdominal skin was stained. Embolization of the HFA before chemoembolization for hepatocellular carcinoma was performed in 4 patients to prevent abdominal wall injury.


RESULTS
Among 25 patients, the HFA arose as a terminal branch of the middle hepatic artery in 14 patients (56%) and of the left hepatic artery in 11 patients (44%). The vessel was single in 18 patients (72%) and double in 7 patients (28%). Two vessels ran side by side along the hepatic falciform ligament. On CTHA, the HFA ran within the hepatic falciform ligament and the branches were connected with the liver around the hepatic falciform ligament. After indigocarmine dye injection, the stain of abdominal skin was recognized in all 6 patients. No abdominal wall injury occurred in any of the 4 patients who were subjected to hepatic chemoembolization.


CONCLUSIONS
HFA is an extrahepatic pathway which runs to the abdominal wall. Before chemoembolization of the middle or left hepatic artery for hepatic malignancy, the HFA should be recognized.
Department of Radiology, Faculty of Medicine, Kagoshima University, Japan.
Y
Y
Baba
N
N
Miyazono
K
K
Ueno
I
I
Kanetsuki
H
H
Nishi
H
H
Inoue
M
M
Nakajo
D000009:Abdominal Muscles / Q000098:blood supply; D000328:Adult; D000368:Aged; D000792:Angiography; D016461:Chemoembolization, Therapeutic; D004396:Coloring Agents; D005260:Female; D006499:Hepatic Artery / Q000000981:diagnostic imaging; D006801:Humans; D007203:Indigo Carmine; D008099:Liver / Q000098:blood supply*; D008113:Liver Neoplasms / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
D004396:Coloring Agents; D007203:Indigo Carmine