Right gastroepiploic artery
pseudoaneurysms are rare, and even rarer in the development of a venous fistula.
1: splenic artery, 2: splenic vein, 3: posterior gastric artery, 4: splenic arteries of the first order 5: splenic arteries of the second order, 6: superior polar artery 7: left gastroepiploic artery
8: spleen, 9: stomach, and 10: pancreas.
Finally, short gastric vessels and the left gastroepiploic artery
are preserved, keeping spleen's blood supply, avoiding the postsplenectomy immunological and hematological complications.
At operation, the left ITA was anastomosed to the LAD and the gastroepiploic artery
(GEA) to the distal RCA using a surgical microscope.
showed in their study that overall early (4 to 21 days after surgery) patency rate of the skeletonised gastroepiploic artery
was 98.2% (599 out of 610 anastomoses).
Flow capacity of gastroepiploic artery
. Ann Thorac Surg 2005; 80: 124-30.
The gastroepiploic artery
has long been used in arterial grafting.
Under local anesthesia (Lidocaine 2%) and using the Seldinger technique, a selective celiac axis catheterization (Cobra Glidecath, 5F, 65-cm-long) with a guidewire (Radifocus guidewire, 0.035", 150-cm-long) confirmed the large right gastroepiploic artery
pseudoaneurysm (Figure 2).
These revealed an anatomic variant with absence of the left gastroepiploic artery
(left gastroomental artery), the gastroepiploic arch being exclusively formed by the right gastroepiploic artery
(right gastroomental artery), and consecutively a separate origin of the LOA (left omental branch) from an inferior pole splenic artery (Figures 2 and 3).
The vessel was seen from the left gastroepiploic artery
to the tumor.
Other arteries including the radial artery, gastroepiploic artery
(GEA) and inferior epigastric artery (IEA) along with the internal mammary arteries (IMA) then started being employed leading to the use of multiple arterial grafting in CABG.4
In order of frequency of use, graft arteries include the internal mammary arteries (IMAs), radial arteries (RAs), right gastroepiploic artery
, and inferior epigastric artery.