title: Analysis of the origin of the right inferior phrenic artery in 178 patients with hepatocellular carcinoma treated by chemoembolization via the right inferior phrenic artery.
abstract: BACKGROUND
  No previous report has described the level of the origin of the right inferior phrenic artery (RIPA) based on an analysis of the relationships between the level of the RIPA, the celiac artery (CA), the superior mesenteric artery (SMA), and the right renal artery (RRA) in a series of cases.
  
  
  OBJECTIVE
  To evaluate the origin of the RIPA by retrospectively analyzing angiographic findings in 178 patients with hepatocellular carcinoma (HCC) who underwent transcatheter arterial chemoembolization (TACE) via the RIPA.
  
  
  METHODS
  In patients treated with intraarterial chemoembolization for HCC, additional superselective chemoembolization of the RIPA branches was necessary in 178 cases. We analyzed the level of the origin of the RIPA in these patients according to the relationships between the level of the origin of the RIPA, the CA, the SMA, and the RRA on angiography.
  
  
  RESULTS
  Among the 178 cases, the RIPA arose from 1) the aorta directly in 102 cases (57%), 2) the CA in 53 (30%), 3) the left gastric artery (LGA) in three (2%), 4) the dorsal pancreatic artery (DPA) in one (1%), and 5) the RRA in 19 (11%). The level of the origin of the RIPA that originated directly from the aorta was supraceliac in 56 cases (32%), between the CA and the SMA in 31 (17%), and between the SMA and the RRA in 15 (8%).
  
  
  CONCLUSIONS
  In our study, the RIPA originated from the aorta between the CA and the SMA directly in 17% of cases. When it is difficult to identify the origin of the RIPA, we must keep in mind that the RIPA may originate from the right part of the aorta within the small distance between the SMA and the CA.
authors.affiliation: Department of Radiology, Fukuoka University Hospital, 7-45-1 Nanakuma, Jyonan-ku, Fukuoka City, Fukuoka 814-0180, Japan. shiro_k@d1.dion.ne.jp
authors.forename: S
authors.initials: S
authors.lastname: Kimura
authors.forename: M
authors.initials: M
authors.lastname: Okazaki
authors.forename: H
authors.initials: H
authors.lastname: Higashihara
authors.forename: Y
authors.initials: Y
authors.lastname: Nozaki
authors.forename: M
authors.initials: M
authors.lastname: Haruno
authors.forename: H
authors.initials: H
authors.lastname: Urakawa
authors.forename: S
authors.initials: S
authors.lastname: Koura
authors.forename: Y
authors.initials: Y
authors.lastname: Shinagawa
authors.forename: M
authors.initials: M
authors.lastname: Nonokuma
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000628:therapy; D002445:Celiac Artery / Q000000981:diagnostic imaging; D016461:Chemoembolization, Therapeutic; D003097:Collateral Circulation; D005260:Female; D006801:Humans; D008102:Liver Circulation; D008113:Liver Neoplasms / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000628:therapy; D008297:Male; D017538:Mesenteric Artery, Superior / Q000000981:diagnostic imaging; D008875:Middle Aged; D011859:Radiography; D012077:Renal Artery / Q000000981:diagnostic imaging; D012189:Retrospective Studies