Importance of Omental Branches Other Than Diagonals in Coronary Circulation
Yes, omental branches beyond diagonal branches have significant clinical importance, particularly in the context of hepatocellular carcinoma treatment and peritoneal pathologies.
Omental Branches in Hepatic Vascular Supply
Omental branches play a crucial role in hepatocellular carcinoma (HCC) treatment, especially in cases where the normal hepatic arterial supply is compromised:
- Transcatheter arterial embolization (TAE) through omental branches has been established as a viable treatment option for HCC when these branches provide collateral blood supply 1
- In 80% of cases requiring omental branch embolization, attenuation or occlusion of the normal hepatic artery was observed, highlighting the importance of these vessels as alternative supply routes 1
- Technical success rate of embolization through omental branches was 73%, demonstrating their accessibility and utility in interventional procedures 1
Clinical Significance in Peritoneal Pathology
Omental branches have demonstrated importance in various pathological conditions:
- They can provide significant blood supply to recurrent disseminated peritoneal leiomyomatosis, as documented in cases where omental arteries (branches from right gastroepiploic artery) became the primary blood supply to pathological tissues 2
- In inflammatory and neoplastic diseases involving the omenta, CT imaging shows that omental branches can be involved in both abscess formation and neoplastic processes 3
- Omental branches can develop into hypertrophied vessels in certain pathological conditions, requiring targeted intervention 2
Diagnostic Considerations
When evaluating omental branches:
- CT imaging is particularly valuable for assessing inflammatory versus neoplastic involvement of omental branches 3
- The presence of gas within omental structures on imaging might prioritize abscessation as a diagnosis 3
- CT findings can help determine surgical feasibility based on the extent of local invasion, especially involvement of structures passing through the porta hepatis 3
Treatment Implications
Understanding the importance of omental branches has direct implications for treatment:
- Successful embolization of omental branches can achieve hepatic hemostasis in patients with ruptured HCC 1
- However, tumor recurrence rate remains high (80%) after successful TAE of omental branches, suggesting the need for additional therapeutic approaches 1
- The safety profile of omental branch embolization appears favorable, with no severe complications reported in available studies 1
Conclusion
While diagonal branches of coronary arteries receive significant attention in cardiac pathology, omental branches beyond diagonals have demonstrated critical importance in hepatic vascular supply, peritoneal pathologies, and as targets for interventional procedures. Their role as collateral circulation in hepatocellular carcinoma and their involvement in peritoneal disease processes highlight their clinical significance beyond the more commonly discussed diagonal branches.