Variations of celiac axis, common hepatic artery and its branches in 600 patients

Abstract

Purpose:To evaluate the spectrum of celiac axis, common hepatic artery (CHA), right, left, middle hepatic artery and gastroduodenal artery variations by using spiral computed tomography (CT).Materials and Methods:A retrospective review of Multidetector CT (MDCT) abdominal angiography scans was performed in patients sent for various liver and other abdominal pathologies between January 2012 and February 2013. A total of 600 patients were evaluated. Definitions of CHA, ambiguous celiac axis, course and division patterns of CHA, replaced hepatic artery, accessory hepatic artery and middle hepatic artery were used as proposed by Song et al., Covey et al., and Wang et al. The pattern of the aortic origin of branches of celiac axis, common hepatic artery and its branches was analyzed.Results:Six types of celiac axis anatomic variations were identified in our study. A total of 546 of the 600 patients had a normal celiac axis anatomy. Anatomic variations were seen in 5.5% of patients. Ambiguous anatomy was seen in 3.5% of the patients. CHA originated from celiac axis in 95.83% of the patients. Variations in anatomic origin of CHA were seen in 8 patients. Ambiguous dual pathway was seen in 4 patients. Normal Sp-preportal course of CHA was identified in 97.78% of cases, Sp-retroportal course in 7 patients, Tp-preportal course in 2, Tp-retroportal in 1, Ip-preportal in 1 and through Ligamentum venosum in 2 patients. Normal origin of RHA from HAP was seen in 79.6% patients. Replaced origin of RHA was seen in 15.16% cases and Accessory origin of RHA was seen in 5.16% cases. LHA originated from HAP in 81.5% patients. Replaced LHA origin was seen in 10.8% cases and Accessory LHA origin seen in 7.6% cases. MHA originated from RHA in 41.3% patients, LHA in 27.83% and from CHA in 4.5% cases. Origin of MHA could not be defined in 26.3% of patients. GDA originated from CHA in 97.6% of patients, from celiac axis in 1.6%, from RHA in 0.33% in patients. Trifurcation of CHA was seen in 7.16% and quadrifurcation of CHA in 2.16%.Conclusion:CT Angiography is a safe and highly sensitive and accurate modality for evaluation of arterial anatomy and its variants.

Prevalence-of-Anatomical-Celiac-Trunk-Variations-Using-3D-AngiographyComputed-Tomography-Images-in-a-Reference-Hospital

“…The prevalence of anatomical variations of the CeT found in this study was three times higher than that reported in other studies ranging from 10-12% [4,5,14,24,25]. This difference should be revalidated in other studies with a bigger Latin American population, but at this time we didn't found any study using latin american patients.…”

Study of Aberrant Hepatic Arteries and Its Relevance in Trans-Arterial Embolization Therapy in Hepatictumours

“…Regarding aberrant left hepatic artery they observed 90 cases (18 %) of ReLHA and 175 cases (35 %) of AcLHA -a total of 265 cases (53 %) aberrant left hepatic artery. Sureka et al [11] found ReRHA (15.16 %) , AcRHA (5.16%) , ReLHA (10.8%) , AcLHA (7.6%) in their study. In Adachi study [12] AcLHA arose from LGA in 17.9% and AcRHA from SMA in 10.3%.…”

Surgical anatomy of the omental bursa and the stomach based on a minimally invasive approach: different approaches and technical steps to resection and lymphadenectomy

“…Interruption of the circles, by anatomical variation or by dissection may produce inadvertent ischemia of the gastric tube leading to complications. CT angiography, performed nowadays more frequently should be carefully studied before surgery to anticipate those anatomical variations (19). Interesting is to know the gastrocolic vein of Henle and the variable course of the left gastroepiploic vein that runs in 30% of the patients in front of the common hepatic artery and in 70% behind it.…”