Replaced right hepatic artery arising from the distal renal artery, a new variation

Vas, Daniel; Rojas, Julián; Garcia, Marta Solà

doi:10.1007/s00276-022-03017-3

Cited by 4 publications

(6 citation statements)

References 14 publications

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“…It may originate from the SMA, proper hepatic artery, aorta, left gastric artery and splenic artery. According to the present literature, replaced RHA is present in 5 to 21% of cases and the accessory RHA is present in 1 to 8% of cases [ 2 , 4 , 5 , 18 , 19 , 30 , 32 ]. Replace RHA (Michel Type III) arises from the SMA, passes laterally and posterior to the portal vein and posterolateral to the bile duct, enters the hepatoduodenal ligament and can be palpated at the foramen of Winslow [ 2 , 4 , 18 ] ( Figure 4 ).…”

Section: Hepatic Artery Variations On the Basis Of Anatomical And Rad...mentioning

confidence: 99%

“…aRHA is the most commonly present variation of the hepatic artery in the population with an incident rate of 15 to 35% [ 4 , 5 ]. According to some literature, the incidence rate is as high as 49% [ 30 , 31 ]. aRHA is one of the most clinically prevalent conditions to be attended carefully in patients undergoing pancreaticoduodenectomy.…”

Section: Hepatic Artery Variations On the Basis Of Anatomical And Rad...mentioning

confidence: 99%

“…Replace RHA (Michel Type III) arises from the SMA, passes laterally and posterior to the portal vein and posterolateral to the bile duct, enters the hepatoduodenal ligament and can be palpated at the foramen of Winslow [ 2 , 4 , 18 ] ( Figure 4 ). During the course, replace RHA passes behind or through the head of the pancreas or close to the hepatocystic triangle, making it more susceptible during laparoscopic pancreatoduodenectomy and cholecystectomy [ 30 ]. In 2% of cases, aRHA arises from the aorta; very rarely, less than 1% of cases originated from the splenic and left gastric artery.…”

Section: Hepatic Artery Variations On the Basis Of Anatomical And Rad...mentioning

confidence: 99%

“…According to some researchers, aRHA originates from the celiac trunk and CHA passes superior to the common bile duct identified as the superior aRHA, and that which arises from the SMA passes inferior to the common bile duct known as inferior aRHA. The later needed more clinical attention at the time of pancreatic and biliary surgery [ 2 , 30 ].…”

Section: Hepatic Artery Variations On the Basis Of Anatomical And Rad...mentioning

confidence: 99%

“…aRHA originates from the major vessel, which has a larger diameter and also supplies a larger area of liver lobes. The replaced RHA has a beneficial effect in liver transplantation as it supplies a larger area of the liver and provides a larger artery for the anastomosis [ 30 ]. Accessory RHA supplying the liver has a beneficial effect in the form of collateral circulation to prevent liver ischemia in case of main vessel injury [ 2 , 19 ].…”

Section: Hepatic Artery Variations On the Basis Of Anatomical And Rad...mentioning

confidence: 99%

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Importance of Anatomical Variation of the Hepatic Artery for Complicated Liver and Pancreatic Surgeries: A Review Emphasizing Origin and Branching

Malviya

Verma

2023

Diagnostics

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Knowledge of anatomical variations of the hepatic artery from its origin to intrahepatic segmentation is of utmost importance for planning upper abdominal surgeries including liver transplantation, pancreatoduodenectomy, and biliary reconstruction. The origin and branching pattern of the hepatic artery was thoroughly described by the classification of Michels and Hiatt. Some rare variations of the hepatic artery were classified by Kobayashi and Koops. By the use of the multidetector computed tomography (MDCT) technique, the branching pattern of the hepatic artery can be visualized quite accurately. Unawareness of these arterial variations may lead to intraoperative injuries such as necrosis, abscess, and failure of the liver and pancreas. The origin and course of the aberrant hepatic arteries are crucial in the surgical planning of carcinoma of the head of the pancreas and hepatobiliary surgeries. In liver transplant surgeries, to minimize intraoperative bleeding complications and postoperative thrombosis, exact anatomy of the branching of the hepatic artery, its variations and intrahepatic course is of utmost importance. This review discusses variations in the anatomy of the hepatic artery from its origin to branching by the use of advanced imaging techniques and its effect on the liver, pancreatic, biliary and gastric surgeries.

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Section: Hepatic Artery Variations On the Basis Of Anatomical And Rad...mentioning

confidence: 99%

Section: Hepatic Artery Variations On the Basis Of Anatomical And Rad...mentioning

confidence: 99%

Section: Hepatic Artery Variations On the Basis Of Anatomical And Rad...mentioning

confidence: 99%

Section: Hepatic Artery Variations On the Basis Of Anatomical And Rad...mentioning

confidence: 99%

Section: Hepatic Artery Variations On the Basis Of Anatomical And Rad...mentioning

confidence: 99%

See 3 more Smart Citations

Importance of Anatomical Variation of the Hepatic Artery for Complicated Liver and Pancreatic Surgeries: A Review Emphasizing Origin and Branching

Malviya

Verma

2023

Diagnostics

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Multidetector computed tomography angiography study of the renal arterial vasculature anatomy and its variations in a Bulgarian adult population

2023

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Purpose: Renal arterial anatomy has a great clinical importance during surgical and endovascular procedures. However, comprehensive data on the renal arterial variations in the Bulgarian population has not yet been provided. The aim of this study was to conduct detailed research about the normal anatomy and variations of the renal arteries in the Bulgarian population. Methods: Five hundred sixty one patients underwent contrast-enhanced multidetector computed tomography scans for the period 2016-2021. The images were retrospectively reviewed. Number, branching pattern, origin level and course of the renal arteries were noted. Data was categorized on the basis of laterality, gender and symmetry.Results: Only 46.3% of the patients exhibited normal renal arterial anatomy. Variations were observed in 301 patients (53.7%). The most common variant was the presence of accessory renal arteries (ARA), discovered in 41.2% of the subjects. There was no signi cant difference based on gender and laterality (p>0.05). Hilar ARA (72.6%) were signi cantly more common than polar ARA (p<0.001). The most common origin location of main renal arteries and ARA was the aorta, followed by the common iliac arteries. Early division was observed in 21.7% of the patients, signi cantly more common on the right. Precaval course was found in 0.5% of the right main renal arteries and in 30% of ARA and the difference was signi cant (p<0.001).Conclusion: These results show novel insight into the prevalence of renal arterial variations in Bulgarian population. Anatomic renal vasculature variants are common therefore awareness is crucial for the success of surgical and interventional procedures.

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Rare and Combined Hepatic Artery Variants as Seen in Cadaveric and Postmortem Investigations: Anatomical Implications in Surgical Practice

Ande,

Makani,

Nannam

et al. 2023

Nigerian Journal of Basic and Clinical Sciences

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Context: Vascular variations are an unexpected finding during cadaveric dissections, postmortems, and surgical and diagnostic angiographic procedures. Usually, such abnormalities are asymptomatic, but the existence of hepatic vasculature anomalies might cause accidental injuries to the vasculature while performing surgical procedures. Aim: This study aimed to dissect human cadavers and postmortem specimens and to examine the variations of the hepatic artery system. Materials and Method: This study was conducted on 50 specimens, with 22 conducted in the dissection hall cadavers, while 28 were collected from the postmortem among the South Indian population irrespective of age and sex and investigated for variant hepatic arteries. The data were collected between January 2014 and December 2015. Results: The results of this study demonstrated that the common hepatic artery (CHA) originated directly from the aorta in 2%, and it was trifurcated into the right hepatic artery (RHA), left hepatic artery (LHA), and gastroduodenal artery (GDA) in 8%. It continued only as the LHA in 16% and only as RHA in 4%. The RHA arises from CHA in 8%, from the superior mesenteric artery (SMA) in 10%, from GDA in 4%, and from replaced CHA in 2%. The GDA accounted for 4% of the accessory RHA's origin, while the proper hepatic artery (PHA) accounted for 2%. The LHA from the CHA in 8% replaced the origin from the left gastric artery (LGA) in 4% and replaced CHA in 2%. The middle hepatic artery was noticed in 62% of the specimens. Conclusion: Surgeons and radiologists participating in angiographic procedures must have up-to-date knowledge of hepatic artery normal variant abnormalities.

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Replaced right hepatic artery arising from the distal renal artery, a new variation

Cited by 4 publications

References 14 publications

Importance of Anatomical Variation of the Hepatic Artery for Complicated Liver and Pancreatic Surgeries: A Review Emphasizing Origin and Branching

Importance of Anatomical Variation of the Hepatic Artery for Complicated Liver and Pancreatic Surgeries: A Review Emphasizing Origin and Branching

Multidetector computed tomography angiography study of the renal arterial vasculature anatomy and its variations in a Bulgarian adult population

Rare and Combined Hepatic Artery Variants as Seen in Cadaveric and Postmortem Investigations: Anatomical Implications in Surgical Practice

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