Unclassified variants of hepatic artery discovered on a 40 slice multidetector CT scanner

Abstract

CT angiography is a common modality used to study the anatomy of hepatic arterial system. Literature reports various unclassified variants of hepatic artery, which prompted us to take this study to see the same in our cohort of population. CT angiograms were performed using 40 slice CT scanner on 110 patients for the investigation of arterial variants in case of hepatic donors and patients for aortic evaluation with angiography. The Results were analyzed as per Michels as well as Modified Michels / Hiatt classification of Hepatic artery variants. The typical/classical most common anatomy (type I variant) as proposed by Michels in 1955, was Right and left hepatic artery arising from common hepatic artery which is a branch of celiac artery. In our study we did not find any type X variant and more so vascular anatomy in 5 patients (8%) did not fit into Michels' classification or Modified Michels/Hiatt classification. These variants have not been reported before, and its importance lies in the fact that variants can predispose to increased risk of surgical complications during liver transplantation and hepatobiliary surgery. It may also influence the choice of vascular technique and materials used in interventional procedures.