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Published on: September 20, 2020
Shepherd's hook technique for superselective catheterization of hepatic arteries
Hyo-Cheol Kim1, Jin Wook Chung1
1Department of Radiology, Seoul National University College of Medicine; Institute of Radiation Medicine, Seoul National University Medical Research Center; and Clinical Research Institute and Department of Radiology, Seoul National University Hospital, # 101 Daehak-ro, Jongno-gu, Seoul 110-744, Korea.
The shepherd's hook technique successfully enabled superselective hepatic artery catheterization in 86% of patients. This interventional radiology method is effective for complex hepatic artery anatomies.
Area of Science:
- Interventional Radiology
- Vascular Surgery
- Medical Devices
Background:
- Superselective catheterization of the hepatic artery is crucial for various interventional procedures.
- Complex arterial geometry, including acute or obtuse angulation, often poses challenges for catheter navigation.
- The shepherd's hook technique is a specialized approach designed to navigate tortuous vessels.
Purpose of the Study:
- To evaluate the efficacy and success rate of the shepherd's hook technique for superselective catheterization of the hepatic artery.
- To identify specific anatomical challenges where the shepherd's hook technique proves most beneficial.
Main Methods:
- The shepherd's hook technique was employed in 21 patients requiring superselective hepatic artery catheterization between October 2013 and March 2014.
- Patient selection criteria included acute angulation (< 60 degrees), right-angle takeoff of small feeder arteries, and complex parent artery configurations.
Main Results:
- The shepherd's hook technique achieved successful superselective catheterization in 18 out of 21 patients, demonstrating an 86% success rate.
- The technique was particularly useful in cases with acute angulation (14 patients), right-angle origins (6 patients), and complex parent arteries (1 patient).
Conclusions:
- The shepherd's hook technique is a valuable and effective tool for achieving superselective catheterization of hepatic arteries.
- Its utility is pronounced in cases involving challenging vascular anatomy, improving procedural success rates in interventional radiology.
