Aberrant arc between the common hepatic artery and a replaced right hepatic artery resulting in misperfusion in a patient with a hepatic arterial infusion pump
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Hepatic arterial infusion pumps are increasingly utilized as an option for liver directed therapy in the treatment of metastatic colorectal carcinoma. After skeletonization of the hepatic artery through the ligation of extra-hepatic branches, these pumps are implanted surgically with their tip placed in the common hepatic artery. Subsequently, a nuclear medicine pump study is performed to ensure homogeneous perfusion of the liver and detect any extrahepatic perfusion. We report a peripheral arc between the superior mesenteric artery and celiac axis, which caused misperfusion on the SPECT nuclear medicine scan.
KeywordsHepatic artery variants Hepatic artery Celiac artery Superior mesenteric artery Misperfusion Hepatic artery infusion pump Colorectal cancer
OH: Manuscript writer/editor, interventional radiology fellow, participated in the interventional radiology portion of the case. SG: Manuscript writer/editor, surgical oncology fellow, participated in the surgical portion of the case. TK: Manuscript writer/editor, attending surgeon for the pump insertion. DC: Manuscript writer/editor, attending surgeon assisting with pump insertion. JK: Manuscript writer/editor, nuclear medicine attending, interpreted pump studies. JN: Manuscript writer/editor, interventional radiology attending for angiographic portion of the case.
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Conflict of interest
The authors have no conflicts of interest to disclose.
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