| Objective: To examine and analyse digital subtraction angiography(DSA)manifestations and characteristics of superior mensenteric artery(SMA)feeding hepatocarcinoma for interventional therapy. Methods: DSA manifestations of interventional treatment in 38hepatocarcinomas with blood-supply arising from SMA were retrospectivelyreviewed. The feeding arteries arising from SMA were divided into two types:aberrant hepatic arterial blood supply,extrahepatic arterial blood supply(collaterals arteries and parasitic arteries). Angiographical manifestations ofdifferent type were described and analysed, frequency and characteristics weresummed up statistically. 50 cases with hepatocarcinoma fed by celiactrunk-hepatic artery were looked as control group, the successful rate ofselective catheterization in 28 hepatocarcinomas fed by aberrant hepaticarteries arising from SMA was calculated and compared with the rate ofcontrol group. Results: (1)Of 378 hepatocarcinoma patients, 38 cases with bloodsupply arising from SMA were found, including aberrant hepatic arteries 28cases,extrahepatic arterial blood supply 10 cases (collaterals blood supply 5cases,parasitic arteries blood supply 5 cases). Among 28 cases with aberranthepatic arteries, including accessory right hepatic artery (9cases,32.1%),replaced right hepatic artery (12 cases,42.9%), aberrant commonhepatic artery (5 cases,17.9%) and celiac artery arising from SMA (2cases,7.1%). Analysing the configuration of aberrant hepatic arteries arisingfrom SMA, we found short-shaft form in 22 cases, short-shaft form in 6 cases;21 cases angulated upward, 7 cases angulated downward. The state of bloodsupply of hepatocarcinoma fed by aberrant hepatic arteries arising from SMAwas divided into full blood supply type,major blood supply type and smallamounts blood supply type, the percentage of three types was 64.2%,25%,10.7%; the right hepatic lobe hepatocarcinomas fed by aberrant hepaticarteries arising from SMA were 20 cases, accounting for 71.4%.(2)On theangiography of 10 cases fed by collaterals and parasitic arteries arising fromSMA, branches of SMA like inferior pancreaticoduodenal artery,right colicartery became thick and twist obviously, "One-way valve occlusion" ofcommon hepatic artery was found in 3 cases with collaterals blood supplythrough pancreaticoduodenal arcade.(3)The successful rate of selectivecatheterization of aberrant hepatic arteries arising from SMA was 67.2%, therate of control group was 82.4%,the difference between the two groups weresignificant(P<0.05).The successful rate of selective catheterization ofcollaterals,parasitic arteries arising from SMA was 46.2%. Conclusion: SMA was very important in supplying blood tohepatocarcinoma, aberrant hepatic arteries,collaterals arteries,parasiticarteries were three pathways that SMA fed hepatocarcinoma, mastering theDSA manifestations and characteristics and choosing proper catheter andmaking use of microcatheter had important and instructional significance ininterventional therapy. |
