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Published on: June 18, 2020
Right gastric venous drainage: angiographic analysis in 100 patients
Nak Jong Seong1, Jin Wook Chung, Hyo-Cheol Kim
1Division of Intervention, Department of Radiology, Seoul National University Bundang Hospital, Gyeonggi-do 436-707, Korea.
Insights
Aberrant right gastric veins (ARGVs) are more common than previously thought. These veins may play a dominant role in gastric venous drainage, impacting treatment strategies.
Area of Science:
- Interventional Radiology
- Vascular Anatomy
- Hepatobiliary Imaging
Background:
- Understanding gastric venous drainage is crucial for interventional procedures.
- Aberrant venous pathways can influence treatment efficacy and complications.
Purpose of the Study:
- To characterize the pattern of right gastric venous drainage.
- To evaluate the incidence and drainage patterns of aberrant right gastric veins (ARGVs).
Main Methods:
- Retrospective analysis of digital subtraction angiography in 100 patients undergoing transcatheter arterial chemoembolization.
- Assessment of right and aberrant gastric vein presence, multiplicity, drainage sites, and termination patterns.
Main Results:
- 66 ARGVs were identified in 49 patients.
- Common drainage sites included hepatic segments IV and I.
- Four distinct termination patterns were observed, with superficial parenchymal blush being most frequent.
- A statistically significant difference in right gastric vein dominance was noted in patients with ARGVs.
Conclusions:
- The incidence of ARGVs is higher than anticipated.
- ARGVs exhibit diverse termination patterns.
- The right gastric vein may be the dominant vessel in gastric venous drainage.
Objective:
To evaluate the pattern of right gastric venous drainage by use of digital subtraction angiography.
Materials And Methods:
A series of 100 consecutive patients who underwent right gastric arteriography during transcatheter arterial chemoembolization for hepatocellular carcinoma were included in this study. Angiographic findings were retrospectively analyzed with respect to the presence or absence of the right and aberrant gastric veins, multiplicity of draining veins, aberrant right gastric venous drainage sites, and the termination pattern of aberrant right gastric veins (ARGVs). We also compared the relative size of the right and left gastric veins.
Results:
A total of 49 patients collectively had 66 ARGVs. The common drainage sites for the ARGVs included the hepatic segment IV (n = 35) and segment I (n = 15). The termination pattern of ARGV could be classified into 4 different types. The most common type was termination as a superficial parenchymal blush formation in small areas without demonstrable portal branches. A statistically significant difference was found for the dominancy of the right gastric vein in gastric venous drainage between the two groups with or without ARGV (p < 0.05, Fisher's exact test). In the group of patients without ARGV (n = 51), the right gastric vein was equal to (n = 9) or larger than (n = 17) the left gastric vein in 26 patients (26 of 51, 51%).
Conclusion:
The incidence of ARGV is higher than expected with four distinct types in its termination pattern. The right gastric vein may play a dominant role in gastric venous drainage.
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