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    Anomalous Branch of the Left Hepatic Artery With Pericardial, Diaphragmatic, Splenic and Gastric Supply During Selective Internal Radiotherapy (SIRT)

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    Authors
    Karim, N. H.
    Bell, J.
    Mullan, D.
    Lawrance, J.
    Najran, P.
    Affiliation
    The Christie NHS Foundation Trust · Manchester, GBR
    Issue Date
    2021
    
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    Abstract
    Selective internal radiotherapy (SIRT) is an established modality for the treatment of hepatic malignancy. The procedure is normally carried out in two parts. The first part involves a planning or "work-up" angiogram to delineate anatomy and plan safe yttrium-90 (Y90) delivery, and the second part for the administration of the Y90 microspheres. The work-up angiogram has three main purposes including delineation of hepatic and tumor vascular anatomy, which might influence the administration of the microbeads, identification, and embolization of blood vessels, which may complicate treatment or contribute to non-target Y90 microsphere deposition and administration of technetium 99 (metastable) labeled macroaggregated albumin (99mTcMAA) at the planned administration points prior to the same day single-photon emission computed tomography (SPECT) or planar SPECT to identify sites of 99mTcMAA uptake. We present the case of a SIRT procedure that demonstrated an anomalous artery arising from the left hepatic artery with supply to the pericardium, diaphragm, fundus of the stomach, and spleen. This is a rare vascular variant that highlights the importance of thorough assessment of both the planning angiograms and SPECT CT for the presence of anatomical variants and abnormal extrahepatic 99mTcMAA uptake to help reduce the need to recall patients for repeat work-up procedures.
    Citation
    Karim NH, Bell J, Mullan D, Lawrance J, Najran P. Anomalous Branch of the Left Hepatic Artery With Pericardial, Diaphragmatic, Splenic and Gastric Supply During Selective Internal Radiotherapy (SIRT). Cureus J Med Sci. 2021;13(12):8.
    Journal
    Cureus Journal of Medical Science
    URI
    http://hdl.handle.net/10541/625004
    DOI
    10.7759/cureus.20373
    Additional Links
    https://dx.doi.org/10.7759/cureus.20373
    Type
    Article
    Language
    en
    ae974a485f413a2113503eed53cd6c53
    10.7759/cureus.20373
    Scopus Count
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    All Christie Publications

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