July 2017 Q & A

Question: Superior Mesenteric Artery to Rt Hepatic Artery

A 5 Fr sheath was placed and attached to a heparinized saline infusion. Exchange was made for a SOS catheter and selective DSA performed in the superior mesenteric artery. Superselective catheterization of the replaced right hepatic artery was then performed using a 3 Fr Progreat Microcatheter and wire. Can a catheter reach the right hepatic artery from the SMA or does the catheter need to go through the celiac artery?

 

Answer:

This is called a replaced right hepatic artery. It is when, as a normal anatomic variant, part of the blood supply to the right lobe of the liver comes off a branch of the SMA. This branch is selected via the SMA. When you inject the Celiac artery, that portion of the liver will not be supplied or seen.