Inferior Phrenic Artery: Anatomy, Variations, Pathologic Conditions, and Interventional Management

Gwon, Dong Il; Ko, Gi‐Young; Yoon, Haesung; Sung, Kyu‐Bo; Lee, Jae Moung; Ryu, Seok Jong; Seo, Myong Hee; Shim, Jae Chan; Lee, Ghi Jai; Kim, Ho Kyun

doi:10.1148/rg.273065036

Cited by 88 publications

(65 citation statements)

References 26 publications

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“…IPA is the most common source of extrahepatic collateral blood supply for hepatocellular carcinoma (HCC) and frequently supplies HCCs located in the bare area of the liver. Therefore anatomy of IPA should be known for surgical treatment of this tumor (9). Knowledge of the anatomical variations of LA is important for surgical operations involving the retroperitoneal region (10).…”

Section: Introductionmentioning

confidence: 99%

Abdominal Aorta and Its Branches: Morphometry - Variations In Autopsy Cases

et al. 2010

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Section: Introductionmentioning

confidence: 99%

Abdominal Aorta and Its Branches: Morphometry - Variations In Autopsy Cases

et al. 2010

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“…The lateral splanchnic branches of Dorsal aorta forms rete arteriosum urogenitale from which adrenal glands, kidneys and gonads draw their arterial supply [6]. The other sources of origins of arteries to adrenal gland involve left gastric, superior mesenteric and spermatic arteries [7].…”

Section: Discussionmentioning

confidence: 99%

A study on the variations of arterial supply to adrenal gland

Lakshmi¹,

Dhoot²

2016

Int J of Biomed & Adv Res

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Introduction: Adrenal glands are richly vascular and get their arterial supply by means of three arteries namely superior, middle, inferior suprarenal arteries. The inferior phrenic artery gives off the superior branch, while middle branch arises directly from the abdominal aorta, and the inferior suprarenal branch is given off by the renal artery. Materials And Methods: The study was conducted in 15 formalin fixed cadavers obtained from the department of Anatomy and are carefully dissected to observe the arterial supply of both right and left adrenal glands. Observations: It has been noted that variations were observed in four cases out of 30 adrenal glands, two cases showed variations on right side and in two cases variation is seen on left side. First case on the right side, both MSA and ISA are given off by ARA. In the second case on right side IPA is given off by RA and from the junction of these two arteries MSA was given. In third case on left side MSA is given by the coeliac trunk and ISA is from ARA, in fourth case on left side ISA is originated from ARA. Conclusion: A good understanding in the variation of adrenal gland vasculature is obligatory for a surgeon while performing adrenalectomy, kidney transplantations etc. and also for radiological arbitrations.

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“…However, no major anatomy textbooks, atlases or previous studies with vast sample sizes mentioned that the ascending and posterior branches of LIPA might originate from different sources as individual arteries (8,(13)(14)(15)(16)(17)(18)(19). Some studies defined these arteries either as accessory left inferior phrenic arteries or cases with a LIPA originating from the RIPA and provided no detail regarding their branches (20)(21)(22). Only a few articles have stated that the branches of the LIPA might arise from different sources as individual arteries (4,(23)(24)(25).…”

Section: Discussionmentioning

confidence: 99%

Inferior Phrenic Arteries and Their Branches, Their Anatomy and Possible Clinical Importance: An Experimental Cadaver Study

Gürses¹,

Gayretli²,

Kale³

et al. 2015

Balkan Med J

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Surgery is the preferred treatment method for hepatic malignancies. Due to advanced tumor stage and accompanying cirrhosis, most cases are considered inoperable at the time of diagnosis (1). It is well known that the blood supply to liver malignancies is typically arterial, unlike the parenchyma, which is supplied by the portal vein (2). Apart from being the main arterial supply to the diaphragm, the right and left inferior phrenic arteries (RIPA and LIPA), are extrahepatic collateral arterial pathways that supply hepatic malignancies, because they neighbor hepatic segments as they traverse the bare area of the liver (3,4). Among the arterial pathways that supply liver malignancies, both RIPA and LIPA constitute nearly half of the collaterals, with RIPA being the most common and LIPA being the 4th or 6 th most common (5,6). Therefore, both RIPA and LIPA are used during transcatheter arterial chemoembolization of liver malignancies (5-7). Furthermore, LIPA gives branches that supply the stomach and esophagus and can be a source of arterial bleeding at the esophagogastric junction (8)(9)(10)(11)(12).In this study, we aimed to investigate the anatomy of the inferior phrenic arteries -with special reference to the branches of the LIPA -and to outline their clinical importance with anatomical pitfalls which we believe may help interventional radiologists.Background: Transcatheter arterial chemoembolization is a common treatment for patients with inoperable hepatocellular carcinoma. If the carcinoma is advanced or the main arterial supply, the hepatic artery, is occluded, extrahepatic collateral arteries may develop. Both, right and left inferior phrenic arteries (RIPA and LIPA) are the most frequent and important among these collaterals. However, the topographic anatomy of these arteries has not been described in detail in anatomy textbooks, atlases and most previous reports. Aims: To investigate the anatomy and branching patterns of RIPA and LIPA on cadavers and compare our results with the literature. Study Design: Descriptive study. Methods: We bilaterally dissected 24 male and 2 female cadavers aged between 49 and 88 years for this study. Results:The RIPA and LIPA originated as a common trunk in 5 cadavers. The RIPA originated from the abdominal aorta in 13 sides, the renal artery in 2 sides, the coeliac trunk in 1 side and the left gastric artery in 1 side. The LIPA originated from the abdominal aorta in 9 sides and the coeliac trunk in 6 sides. In 6 cadavers, the ascending and posterior branches of the LIPA had different sources of origin. Conclusion: As both the RIPA and LIPA represent the half of all extrahepatic arterial collaterals to hepatocellular carcinomas, their anatomy gains importance not only for anatomists but interventional radiologists as well.

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Inferior Phrenic Artery: Anatomy, Variations, Pathologic Conditions, and Interventional Management

Cited by 88 publications

References 26 publications

Abdominal Aorta and Its Branches: Morphometry - Variations In Autopsy Cases

Abdominal Aorta and Its Branches: Morphometry - Variations In Autopsy Cases

A study on the variations of arterial supply to adrenal gland

Inferior Phrenic Arteries and Their Branches, Their Anatomy and Possible Clinical Importance: An Experimental Cadaver Study

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