Accessory hepatic artery: incidence and distribution Art谷ria hep芍tica acess車ria: incid那ncia e distribui o

作者：Sukhendu Dutta; Bimalendu Mukerjee

来源：Jornal Vascular Brasileiro, 2010.

• Suprimento arterial hepatico
• tronco celiaco
• arteria hepatica acessoria
• arteria suprarrenal
• Liver-arterial supply
• celiac trunk
• accessory hepatic artery
• suprarenal artery

Background: Anatomic variations of the hepatic arteries are common. Preoperative identification of these variations is important to prevent inadvertent injury and potentially lethal complications during open and endovascular procedures. Objective: To evaluate the incidence, extra-hepatic course, and presence of side branches of accessory hepatic arteries, defined as an additional arterial supply to the liver in the presence of normal hepatic artery. Methods: Eighty-four human male cadavers were dissected using a transperitoneal midline laparotomy. The supra-celiac aorta, celiac axis, and hepatic arteries were dissected, and their trajectories were identified to describe arterial branching patterns. Results: Normal hepatic arterial anatomy was identified in 95% of the cadavers and six (5%) had accessory hepatic arteries. In five cadavers the accessory hepatic artery followed its course through the fissure for ligamentum venosum, and in one it coursed adjacent to the hepatic artery through the margin of the lesser omentum. One cadaver had a single side branch, which provided arterial blood supply to the left adrenal gland in the absence of any left inferior phrenic artery. Conclusion: Accessory hepatic artery most often follows the course of the hepatic fissure for ligamentum venosum. Albeit uncommonly found in 5% of cases, this finding should be identified during open and endovascular procedures to prevent inadvertent injury. Contexto: As varia es anat micas das art谷rias hep芍ticas s o comuns. A identifica o pr谷-operat車ria dessas varia es 谷 importante para prevenir les o inadvertida e complica es potencialmente letais durante procedimentos abertos e endovasculares. Objetivo: Avaliar a incid那ncia, o trajeto extra-hep芍tico e a presen a de ramos laterais das art谷rias hep芍ticas acess車rias definidas como um suprimento arterial adicional para o f赤gado na presen a de art谷ria hep芍tica normal. M谷todos: Oitenta e quatro cad芍veres humanos masculinos foram dissecados atrav谷s de laparotomia mediana transperitoneal. A aorta supracel赤aca, o eixo cel赤aco e as art谷rias hep芍ticas foram dissecados, e suas trajet車rias foram identificadas para descrever os padr es dos ramos arteriais. Resultados: Anatomia arterial hep芍tica normal foi identificada em 95% dos cad芍veres, e seis (5%) tinha art谷rias hep芍ticas acess車rias. Em cinco cad芍veres, a art谷ria hep芍tica acess車ria seguia seu trajeto atrav谷s da fissura para o ligamento venoso, e em um caso a art谷ria corria adjacente 角 art谷ria hep芍tica atrav谷s da margem do pequeno omento. Um cad芍ver tinha um ramo unilateral que fornecia san