| Figure 4 58 year old female with hepatic metastatic colorectal
cancer undergoing pre-treatment therapy planning arteriography and embolisation
of vessels supplying the gastrointestinal tract. (a) Celiac Arteriogram
with variant anatomy; showing Splenic artery (thin arrow); Common hepatic
artery (bold arrow) and the variant Gastrohepatic trunk (arrow heads). (b)
Right Hepatic Arteriogram; Catheter tip in right hepatic artery (bold arrow);
Right gastric artery (arrow heads) could not be selectively catheterised
for embolisation. (c) GastroHepatic Trunk Arteriogram; Left gastric artery
(bold arrow)anastomosing with right gastric artery (arrowheads) along the
lesser curvature of the stomach ; note left hepatic artery (thin arrow)
supplying the left lobe of liver. (d) Left Gastric Arteriogram; Selective
3 Fr microcatheter in the left to right gastric artery arcade(thin arrow);
Note reflux into the right hepatic artery at the origin of the vessel (bold
arrow). (e) Right Gastric Artery embolisation; two 3 mm fibred platinum
microcoils deployed from origin of right gastric artery. (f) Gastroduodenal
arteriogram; selective 3 Fr microcatheterisation of origin in preparation
for embolisation. (g) Right Hepatic Arteriogram following embolisation of
the right gastric artery; Gastroduodenal artery (arrow heads) demonstrating
absence of flow to the gastrointestinal tract; Note the diffuse hypervascular
hepatic metastases (arrows). |
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