title: The origin of the cystic artery supplying hepatocellular carcinoma on digital subtraction angiography in 311 patients.
abstract: OBJECTIVE
  This study was designed to investigate the prevalence and patterns of origin of the cystic artery using selective angiography images obtained during chemoembolization.
  
  
  METHODS
  Between March 2007 and January 2012, 326 patients with hepatocellular carcinoma supplied by the cystic artery were treated by chemoembolization through the cystic artery. Fifteen patients were excluded due to the difficulty in determining the origin of their cystic arteries. Thus, a total of 311 patients were included in this study. Digital subtraction angiography images were reviewed retrospectively by consensus.
  
  
  RESULTS
  A total of 112 (36 %) patients had a total of 121 variant hepatic arteries. Double cystic arteries were present in 46 (14.8 %) patients, and total 357 cystic arteries were observed. The origin sites of the cystic artery were the following: the right hepatic artery (n = 248), the anterior sectional artery (n = 44), the segment IV artery (n = 21), the posterior sectional artery (n = 10), the left hepatic artery (n = 8), the proper hepatic artery (n = 8), the gastroduodenal artery (n = 4), and others (n = 14). In total, 103 (33 %) patients had at least one cystic artery arising from arteries other than the right hepatic artery. In patients with right hepatic artery variations, the cystic artery more frequently originated from arteries other than the right hepatic artery (p = 0.003).
  
  
  CONCLUSIONS
  The most and second most common origins of the cystic artery are the right hepatic artery and the anterior sectional artery. In addition, the origin site of the cystic arteries is influenced by variations of hepatic arteries.
authors.affiliation: Department of Radiology, Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center, and Clinical Research Institute, Seoul National University Hospital, #28 Yongon-dong, Chongno-gu, Seoul, 110-744, Korea.
authors.forename: Beomsik
authors.initials: B
authors.lastname: Kang
authors.forename: Hyo-Cheol
authors.initials: HC
authors.lastname: Kim
authors.forename: Jin Wook
authors.initials: JW
authors.lastname: Chung
authors.forename: Saebeom
authors.initials: S
authors.lastname: Hur
authors.forename: Hwan Jun
authors.initials: HJ
authors.lastname: Jae
authors.forename: Jae Hyung
authors.initials: JH
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction / Q000379:methods*; D006528:Carcinoma, Hepatocellular / Q000098:blood supply* / Q000000981:diagnostic imaging* / Q000628:therapy; D016461:Chemoembolization, Therapeutic / Q000379:methods; D005260:Female; D006499:Hepatic Artery / Q000033:anatomy & histology / Q000000981:diagnostic imaging*; D006801:Humans; D008113:Liver Neoplasms / Q000098:blood supply* / Q000000981:diagnostic imaging* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies