Superior Mesenteric Artery to Rt Hepatic Artery

Superior Mesenteric Artery to Rt Hepatic Artery

ZHealth Publishing Coding Q&A

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by David Zielske, MD, CIRCC, COC, CCVTC, CCC, CCS, RCC

Superior Mesenteric Artery to Rt Hepatic Artery
Question:
A 5 Fr sheath was placed and attached to a heparinized saline infusion. Exchange was made for a SOS catheter and selective DSA performed in the superior mesenteric artery. Superselective catheterization of the replaced right hepatic artery was then performed using a 3 Fr Progreat Microcatheter and wire. Can a catheter reach the right hepatic artery from the SMA or does the catheter need to go through the celiac artery?

Answer:
This is called a replaced right hepatic artery. It is when, as a normal anatomic variant, part of the blood supply to the right lobe of the liver comes off a branch of the SMA. This branch is selected via the SMA. When you inject the Celiac artery, that portion of the liver will not be supplied or seen.

About the Author

David Zielske, MD, CIRCC, COC, CCVTC, CCC, CCS, RCC
David Zielske is founder and President of ZHealth Publishing and primary author and editor of ZHealth publications. Dr. Z practiced as an interventional radiologist and has over twenty years experience as a coding reviewer and coding expert. He is Board Certified in Radiology and has functioned as an independent interventional radiology, vascular surgery, and cardiovascular coding consultant to a variety of physician groups and hospital providers across the country. He also served as an instructor for over 200 coding seminars.

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