Posterior gastric artery in angiograms and its surgical importance

The incidence and the clinical importance of the posterior gastric artery (PGA) have not been clarified. In Japan, as in the West, the incidence of adenocarcinoma of the upper stomach has increased recently. The purpose of this study was to clarify the features of the posterior gastric artery by analyzing a large series of digital subtraction angiography, and to determine its clinical significance.

Three hundred and fourteen patients who underwent angiography between 1991 and 2001 at the Kochi Medical School were studied. The length from the root of the splenic artery and the internal diameter of PGA were investigated celiacographically. The correlation of the body mass index (BMI) and the features of PGA were evaluated.

PGA was visualized in 175 patients (55.7%) celiacographically. PGA averaged 3.2-7.4cm (mean 5.4) in length from the root of the splenic artery and the size was 0.7-2.1mm (mean 1.4). The rate of depiction in patients with liver cirrhosis (73.2%) was significantly higher than that in those without (30.5%). No significant difference in length or size of PGA was seen by gender, age, or hepatitis viral infection. No correlation was found between the length or size of PGA and BMI.

Our findings show that the anatomical features of PGA can be visualized by clinical methods useful in planning surgical treatment.