DSA Study Of The Hepatic Atrerial Variations And Its Clinical Significance In Interventional Therapy For Hepatic Cancer

Objective: In all1200cases of DSA guided hepatic artery angiography who wastaken interventional treatment for hepatocellular carcinoma in our treatment.wascollected in the year from2005to2011.Discussion on the classification,incidence andcharacteristics of the anatomic variations of hepatic arteries.Analysis the clinicalsignificance of the Hepatic arterial anatomy mutation in interventional therapy ofhepatocellular carcinoma patients by DSA examination.Methods: In all1200cases of DSA guided hepatic artery angiography who wastaken interventional treatment for hepatocellular carcinoma in our treatment. With thepatient taking the supine position, disinfection the inguinal region skin and drape.5mlof2%lidocaine anesthesia in around of the femoral artery.Using the Seldingertechnology puncture into the femoral artery.then send the4F or5F radiography catheterby the catheter sheath.Insert the celiac trunk in perspective.Bolus the nonionic contrastagent at the speed of4-5ml/s with the pressure of500Pa.Arterial phase andParenchymal phase and Portal venous phase Angiography image are collected.If thereare suspected anatomic variations of hepatic artery or there are Liver area is notdeveloped with no blood supply,we insert the artery of superior mesenteric artery,abdominal aorta, left gastric artery,right renal artery,splenic artery and the inferiorphrenic artery.Observe the variation of hepatic artery comprehensive.TwoInterventional physicians read the origin,Walking,distribution of the hepatic arterytogether.Analysis the Probability of hepatic artery variation.The situation of hepaticartery.deletion mutation and The probability of extrahepatic atery branchs and originposition variation situation.Results: The standard hepatic arterial anatomy was seen in75.25%(903out of1200cases),297cases of hepatic arterial anatomy mutation which was in24.75%.180cases （15%） fit Hiatt classification and Michels＇classification out of the hepatic arterial anatomy mutation. But117patients（9.75%）present a lot of types of anatomicarterial variations of the hepatic arteries which were not reported inMichels’classification. They were variations of common hepatic arterial furcation in65cases, original variations of the hepatic arteries in267cases,combination of furcationand original variations of the hepatic arteries in8cases.We found out that the hepaticartery without the mutation survival longer than variation.Conclusion: The anatomic variation of the hepatic arteries is characterized by astriking degree of polymorphism and complexity.So understanding the anatomicvariations of hepatic artery is very important for Surgeons,radiologists andinterventional physicians to make operation scheme, reduce the operation risk andimprove the accuracy of diagnosis and treatment.It should be carefully observe whetherthe hepatic artery has variation, and Intubation ultraselection as much as possible.