Anatomic variations of the hepatic arteries in 604 selective celiac and superior mesenteric angiographies

Abstract

In modern surgical and transplantation procedures the recognition of anatomic vascular abnormalities of the hepatic arteries is of greater importance than ever. The purpose of this study was to evaluate and classify these variations with respect to their impact on visceral surgery. A total of 604 selective celiac and superior mesenteric angiographies performed on patients with known or suspected liver cirrhosis or hepatic or pancreatic malignancies and on donors of partial liver grafts were analyzed retrospectively. The vascular anatomy of the liver was classified according to different established systems and with particular attention to rare variations. Hepatic arterial anatomy as considered normal in textbook descriptions was found in 79.1%, an aberrant or accessory left hepatic artery (LHA) arising from the left gastric artery in 3.0% and an aberrant or accessory right hepatic artery (RHA) branching off the superior mesenteric artery in 11.9% of the cases. In 1.4% of the cases there was a combination of anomalies of both the LHA and RHA. Variants of the celiac trunk, double hepatic arteries branching at the celiac trunk or hepatic arteries arising directly from the aorta, occurred in 4.1% of the cases. Further atypical branches of the LHA and RHA were found in 0.5% of the cases. Since the incidence and pattern of different types of hepatic arterial anatomy can require specialized preoperative diagnostic as well as intraoperative strategies, knowledge of these abnormalities and their frequency is of major importance for the surgeon as well as the radiologist.

Abnormal Origin and Course of Hepatic Arteries: A Case Report

“…Among the 5 types with variations, the most common was the anomalous origin of the right hepatic artery arising from the superior mesenteric artery (10.6%), which was also found by Gruttadauria et al in 14.98% of the 701 cases studied [5] and Koops et al in 8.6% of the 604 angiograms that compose the study [9]. On the other hand, Koops et al found only 3% of left hepatic artery variations, while Hiatt et al and Gruttadauria et al found 9.7% and 11.5%, respectively [5,9,11]. An early bifurcation of the hepatic artery in right and left as direct branches of the celiac trunk was found in two cases in the study by Koops et al, but in only one of them the gastroduodenal artery originates from the left hepatic artery as presented on the current report [9].…”

“…Hiatt et al, analyzed 1000 liver transplant patients and classified the hepatic vascularization into 6 types [11]. Among the 5 types with variations, the most common was the anomalous origin of the right hepatic artery arising from the superior mesenteric artery (10.6%), which was also found by Gruttadauria et al in 14.98% of the 701 cases studied [5] and Koops et al in 8.6% of the 604 angiograms that compose the study [9]. On the other hand, Koops et al found only 3% of left hepatic artery variations, while Hiatt et al and Gruttadauria et al found 9.7% and 11.5%, respectively [5,9,11].…”

“…On the other hand, Koops et al found only 3% of left hepatic artery variations, while Hiatt et al and Gruttadauria et al found 9.7% and 11.5%, respectively [5,9,11]. An early bifurcation of the hepatic artery in right and left as direct branches of the celiac trunk was found in two cases in the study by Koops et al, but in only one of them the gastroduodenal artery originates from the left hepatic artery as presented on the current report [9]. When it comes to the path of these arteries, the variations are not so common.…”

“…The anatomical variations of the celiac trunk and the hepatic arteries occur frequently from 20.9% to 50% (Koops et al [9]; Ugurel et al [10]) according to different studies. Its classification in well-established standards is difficult because of the great difference of frequency found in different studies and, moreover, by the extremely variable division pattern.…”

Origin of the Celiac and Superior Mesenteric Arteries in a Common Trunk - Description of a Rare Vessel Variation of the Celiacomesenteric Trunk with a Literature Review

“…However, variations in the blood supply of the supramesocolonic organs have been frequently reported [6][7][8][9][10][11][12][13][14][15] . With the development of imaging technology, such as computed tomography (CT), magnetic resonance imaging (MRI), and angiography methods, information regarding vessel variation has become very important.…”