ARTERIAL ANATOMY OF A PREVIOUSLY UNCLASSIFIED VARIANT OF LIVER VESSELS AS A FACTOR INFLUENCING THE EFFICIENCY OF EMBOLIZATION OF SOLID TUMORS USING THE EXAMPLE OF THE ORIGIN OF THE RIGHT HEPATIC AND RIGHT RENAL ARTERIES FROM THE COMMON HEPATIC ARTERY

Solid malignant tumors of the liver parenchyma represent a complex and challenging aspect of modern clinical oncology. A large number of patients already have inoperable disease at the time of diagnosis, necessitating the search for alternative, minimally invasive, and highly effective treatment methods. Liver tumor treatment remains multifaceted and multi-stage, and in recent years has focused on minimally invasive methods, which involve mechanical or chemical interventions targeting the tumor substrate via blood vessels. Tumor blood flow to the liver parenchyma, including areas of abnormal vascularization, is directly dependent on the arterial and anatomical and physiological characteristics of the hepatobiliary system, and the effectiveness of interventional treatments is directly proportional to this circumstance. In the world literature, there are only a small number of scientific publications describing the characteristics of vascular blood supply in a purely observational manner. The first to systematize this topic and identify typical anatomical variants was [Michels N.A., 1955, 1966] and identified 10 variants of celiac trunk vascular anatomy. This classification was simplified by identifying six variants of the anatomical features of the celiac hepatic vessels [Hiatt 1994]. This classification is extremely important when planning operations in the celiac hepatobiliary zone, especially during liver transplantation and resections, to maintain adequate blood supply, as well as to achieve occlusion of all main and collateral vessels feeding the liver tumor when performing X-ray endovascular interventions [1,2,3]. For example, according to a number of authors, there are no clear correlations in the literature between the number of endovascular interventions and the characteristics of the arterial blood supply to the liver described in the classification [4,5]. However, the impact of arterial anatomy variations on clinical and technical success during endovascular surgery remains controversial [6]. This article describes for the first time a previously undescribed variant of arterial blood supply to the visceral branches of the aorta and a previously undescribed variant of the origin of the right hepatic and right renal arteries.