Anatomical variations of the hepatic artery: a closer view of rare unclassified variants

Imam, Ashraf; Karataş, Cihan; Mecit, Nesimi; Afak, K; Yildirimoglu, T.; Kalayoğlu, Münci; Kanmaz, Turan

doi:10.5603/fm.a2021.0024

Cited by 3 publications

(15 citation statements)

References 11 publications

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“…We found that the classic Hiatt and Michel classifications were unsuitable for these rare and complex classifications, and their coverage by the CRL classification was relatively improved, but the specificity for these rare cases was not high. For example, rRHA described by Abdullah et al ( 33 ) in 2006 originated from the inferior mesenteric artery, which is classified as CR rOM L by ex-CRL, and rRHA described by Imam et al ( 25 ) in 2021 was derived from the pancreaticoduodenal artery, which was classified as CR rOD L by ex-CRL, but both cases are represented by CRL classification as “2o (CR rO L)”. The CRL classification does not clearly describe this part of “other arteries”, making it necessary to use ex-CRL for reclassification.…”

Section: Discussionmentioning

confidence: 99%

A rare hepatic artery variant reporting and a new classification

Kang

Liu

et al. 2022

Front. Surg.

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Variations of the hepatic artery are very common, but they greatly increase the difficulty of surgery and the risk of complications in perihepatic surgeries such as liver transplantation, liver segmentectomy, and gastroduodenal surgery. Thus, it is important to precisely define the type of hepatic artery variant before surgery. However, there are often rare variants that cannot be defined with existing classifications. For example, the type of hepatic artery variant in the current case could not be classified with conventional classifications, and no such variation has been reported to date, involving two accessory left hepatic arteries from the common hepatic and left inferior phrenic arteries, respectively. Based on the existing 3DCT technology and the CRL classification method, which is applicable to the most common hepatic artery variants, we reviewed many rare variant types and proposed a new classification method (ex-CRL classification) for hepatic artery variations that do not fit the classic scope. The ex-CRL classification can accurately classify the vast majority of rare cases in the literature, greatly compensates for the limitations of current hepatic artery classifications, improves the generalization and understanding of rare cases, and reduces surgical complications.

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Section: Discussionmentioning

confidence: 99%

A rare hepatic artery variant reporting and a new classification

Kang

Liu

et al. 2022

Front. Surg.

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“…Pediatric solid organ transplantation (SOT) is the treatment of choice for end-stage organ failure (Imam et al, 2020), which allows the medical situation of a child to change from experiencing a lifethreatening disease to having a chronic health condition (Annunziato et al, 2012). Caregivers are an essential figure in SOT; even so, we still have limited understanding of the experience of caregiving through the entire process of transplantation, and there are limited data examining the long-term impact.…”

Section: Introductionmentioning

confidence: 99%

Stress and coping strategies of families of pediatric solid organ transplant recipients in times of pandemic

et al. 2023

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ObjectivePediatric solid organ transplantation (SOT) is a chronic condition that impacts the whole family system. The objective of this study is to evaluate psychopathology, family stress, and coping strategies in families of SOT recipients compared to families of healthy children and adolescents. Moreover, it analyzes if the stress related to the COVID-19 pandemic has had an additional impact on these families.MethodsThe sample was recruited between May and July 2021, during the fourth and fifth wave of the pandemic in Spain. It consisted of 102 families, 51 with a pediatric recipient who had undergone a SOT (liver, kidney, heart, or lung) and 51 healthy controls, matched by child age and gender. A primary caregiver from each family answered an online sociodemographic questionnaire and different tests to evaluate family stress, depression, anxiety, coping strategies, and effects of the pandemic on the family.ResultsCaregivers were mostly mothers (89.2%). Families of SOT recipients showed greater anxiety (U = 863.5, p = 0.003) and more total stress, stress related to childcare (t = −2.043; p = 0.045), and parent–child interaction stress (U = 355.5, p = 0.015). SOT families used more avoidance strategies, specifically denial (U = 889.5; p = 0.010) and abandonment of coping efforts (U = 1,013; p = 0.047), more religious strategies (U = 792.5; p = 0.031), and fewer social support coping strategies (t = 2.098; p = 0.038). No differences were found between groups in terms of exposure, impact, and distress more than 1 year after the start of the pandemic.ConclusionSOT families showed clinical levels of anxiety, more parent–child interaction stress, more difficulties in taking care of their child, more avoidance and religious strategies, and less use of social support strategies, even 4 years after transplantation. The pandemic did not have an additional differential effect on SOT families. Caregivers of SOT patients can benefit from psychological interventions focused on parents’ mental health, parent–child connectedness, skill building, and social support aid groups, with attention to multiculturalism and promoting a better balance between caregivers. There is a need for family interventions that are maintained over time. Strategies that offer this support to families through digital resources can facilitate adjustment to chronic illness, especially in pandemic times.

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“…Hepatic artery variations were studied in detail by various researchers and given the internationally accepted classification. The classification given by Michel and Hiatt is the most popular and acceptable [ 3 , 4 , 5 ]. Michel classified hepatic artery variations into 10 different types and Hiatt classified them into six different types [ 4 , 5 ] ( Table 1 ).…”

Section: Introductionmentioning

confidence: 99%

“…The classification given by Michel and Hiatt is the most popular and acceptable [ 3 , 4 , 5 ]. Michel classified hepatic artery variations into 10 different types and Hiatt classified them into six different types [ 4 , 5 ] ( Table 1 ). According to both, Type I variation is the most common and represents regular branching of the hepatic artery [ 4 , 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

“…Michel classified hepatic artery variations into 10 different types and Hiatt classified them into six different types [ 4 , 5 ] ( Table 1 ). According to both, Type I variation is the most common and represents regular branching of the hepatic artery [ 4 , 5 , 6 ]. Type III variation is the most common abnormal variation affecting upper abdominal surgeries [ 7 , 8 , 9 ].…”

Section: Introductionmentioning

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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Anatomical variations of the hepatic artery: a closer view of rare unclassified variants

Cited by 3 publications

References 11 publications

A rare hepatic artery variant reporting and a new classification

A rare hepatic artery variant reporting and a new classification

Stress and coping strategies of families of pediatric solid organ transplant recipients in times of pandemic

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

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