The origin of the inferior phrenic artery: a study in 32 South Indian cadavers with a review of the literature (original) (raw)
Related papers
International Journal of Research in Medical Sciences, 2015
Background: Inferior phrenic arteries, which constitute the chief arterial supply to the diaphragm, are generally the branches of abdominal aorta, however, variations in their mode of origin is not uncommon. Very less information is available regarding the functional anatomy of the inferior phrenic artery in anatomy textbooks. Methods: The present study was conducted utilizing 36 formaline-fixed cadavers between 22 years to 80 years over a period of 5 years. The frequency and anatomical pattern of the origin of the right and left inferior phrenic arteries were studied. Results: On the right side, the inferior phrenic artery arose independently from abdominal aorta in 94.4% cases and on the left side in 97.2% cases.Other sources of origin were seen in 5.55% cases. Left hepatic artery was seen as the source of origin for right inferior phrenic artery in one case while in second case left gastric artery was the source for both the right and left inferior phrenic artery. The right inferior phrenic artery is the most common source of collateral arterial supply to hepatocellular carcinoma, next to the hepatic artery. Conclusion: Knowledge of variations of inferior phrenic artery origin could be valuable during treatment of hepatic neoplasm, liver transplants, biliary tract surgery and during tanscatheter oily chemoembolisation technique.
Clinical anatomy of the inferior phrenic artery
Clinical Anatomy, 2005
The majority of anatomical textbooks of gross anatomy offer very little information concerning the anatomy and distribution of the inferior phrenic artery (IPA). In the last decade, however, increased numbers of reports have appeared with reference to the arterial supply of hepatocellular carcinoma (HCC). The IPA is a major source of collateral or parasitized arterial supply to this type of carcinoma, second only to the hepatic artery. The aim of this study was to identify the origin and distribution of the IPA (right and left), in normal and pathological cases, and to apply such findings to the clinical scenario of treating hepatic cancer. We have examined 300 formalin-fixed adult cadavers lacking abdominal pathology, and 30 cadavers derived from patients with HCC. Dissections in normal cadavers showed that the right IPA originated from the: a) celiac trunk in 40% of the specimens; b) aorta in 38%; c) renal in 17%; d) left gastric in 3%; and e) hepatic artery proper in 2% of the specimens. The left IPA originated from the: a) celiac trunk in 47%; b) aorta in 45%; c) renal in 5%; d) left gastric in 2%; and e) hepatic artery proper in 1% of the specimens. The IPA gave rise to eight notable branches: ascending, descending, inferior vena cava, superior suprarenal, middle suprarenal, esophageal, diaphragmatic hiatal, and accessory splenic. The right IPA was always associated with HCC and served as the major collateral artery adjunct to the hepatic artery. These findings could have major implications in the transcatheter embolization of HCC patients. Clin. Anat. 18:357-365, 2005. V V C 2005 Wiley-Liss, Inc.
Superior phrenic artery: an anatomic study
Surgical and Radiologic Anatomy, 2007
The majority of anatomical textbooks oVer very little information concerning the anatomy and distribution of the superior phrenic artery (SPA). However, in the last decade, a number of reports have appeared with reference to the transcatheter arterial chemoembolization of the collateral arterial supply of hepatic carcinoma (HC). Considering the potential role of the SPA as a source of collateral blood supply to HC, the aim of this study was to identify the origin and distribution of the SPA. One hundred formalin-Wxed adult cadavers with no evidence of signiWcant gross diaphragmatic pathology were examined. The right SPA originated from the aorta (R1) in 42%, as a branch of the proximal segment of the 10th intercostal artery (R2) in 33%, and as a branch of the distal segment of the 10th intercostal artery (R3) in 25%, of the specimens. The left SPA originated from the aorta (L1) in 51%, from proximal segment of the left 10th intercostal artery (L2) in 40%, and from the distal segment of the left 10th intercostal artery (L3) in 9%, of the specimens. In types R1, R2, L1 and L2 the SPA terminated, after a short course, within the medial and posterosuperior surfaces of the thoracic diaphragm and diaphragmatic crura. Conversely, in types R3 and L3 the lateral origin of the SPAs conWned the ultimate distribution of the vessels to the posterior surface of the diaphragm. These Wndings could provide a better understanding of the anatomy and distribution of the arterial supply of the diaphragm and the potential involvement of the right SPA as an extrahepatic collateral artery developed in HC.
Inferior Phrenic Artery, Variations in Origin and Clinical Implications – A Case Study
Variations in the branching pattern of abdominal aorta are quite common, knowledge of which is required to avoid complications during surgical interventions involving the posterior abdominal wall. Inferior Phrenic Arteries, the lateral aortic branches usually arise from Abdominal Aorta ,just above the level of celiac trunk. Occasionally they arise from a common aortic origin with celiac trunk, or from the celiac trunk itself or from the renal artery. This study describes the anomalous origin of this lateral or para aortic branches in the light of embryological and surgical basis. Knowledge of such variations has important clinical significance in abdominal operations like renal transplantation, laparoscopic surgery, and radiological procedures in the upper abdomen or invasive arterial procedures .
2020
The lack of ample amount of literature, limited size of the study group in the available studies and relating the potential clinical applications of variation of origin of inferior phrenic artery has validated the study so that additional information could be added to the present literature. Objective: Few dedicated studies have been available demonstrating variations in the origin of inferior phrenic in the present growing era of intervention radiology. The cause has been satisfied by studying a group of 100 patients and reviewing the available literature. Methods: A group of 100 patients that were the potential liver and renal donors were studied in a 40 slice CT scanner as pre transplant evaluation in the Department of Radiology, Institute of nuclear medicine and allied sciences, Timarpur, New Delhi. Results: The right inferior phrenic arteries arise from abdominal aorta in 41(42%) of cases, celiac axis 50(50%) ,right renal artery 7(7%) and from left gastric in 2(2%) of cases. Th...
2014
INTRODUCTION: IPA usually originates from aorta as a first lateral branch just above the celiac trunk to supply mainly to the suprarenal gland and the diaphragm. Besides this left IPA may give rise to a small number of branches that serve to supply the superior pole of the spleen and the proximal portion of the stomach. [1] The right IPA potentially communicates with the intra-hepatic arteries and one of the most common sources of extra blood supply to liver as collateral pathways.[2,3] IPA usually develops from lateral splanchnic branch of dorsal aorta. The IPA bud out from the highest suprarenal artery and the permanent renal artery sprouts from the lowest suprarenal artery.[4] The roentgenographic anatomy of phrenic arteries has been described in detail by Kahn et al.[5] Variation of the IPA and their relations to the surrounding structures are important in regard to intra-abdominal surgeries. Ligation or damage to these arteries without knowing the variations during surgical app...
Anomalous Origin of Right Inferior Phrenic Artery
2014
Address for Correspondence: Dr. Banani Kundu, Assistant Professor of Anatomy, R G Kar Medical College, 1, Khudiram Bose Sarani, Kolkata 700 004, India. Mobile: +91 9433366549. E-Mail: dr.bmitra@yahoo.com Access this Article online Quick Response code Web site: *1 Assistant Professor, 2 Post Graduate Trainee, Department of Anatomy, R G Kar Medical College, Kolkata, India. 3 Demonstrator of Anatomy, North Bengal Medical College, Darjeeling, India. 4 Assistant Professor, Department of Pharmacology, College of Medicine & Sagar Dutta Hospital, Kolkata, India. Background: To show the anomalous origin of right inferior phrenic artery from right renal artery and to discuss the embryological basis and surgical significance of such variation. Method: This was found during routine dissection of abdomen in a 61 year old adult male cadaver in the department of anatomy, R.G.Kar Medical College. Results: It was seen that right inferior phrenic artery(RIPA) took its origin from right renal artery. ...
Abdominal Imaging, 2008
Background: The purpose of this study is to assess angiographic and CT appearance of left inferior phrenic artery (LIPA) arising from left hepatic or left gastric artery and to recognize its specific anatomical location with the help of cadaver dissection. Methods: We retrospectively reviewed 761 abdominal angiographies and found 13 patients (1.7%) with LIPA arising from left hepatic or left gastric artery. We classified those origins and assessed radiological features. We also presented a cadaver dissection to identify anatomical location of LIPA arising from left hepatic artery. Results: The origin of the LIPA was classified as follows: (a) left hepatic artery: four, (b) accessory left gastric artery: one, (c) accessory left hepatic artery: three, and (d) left gastric artery: five patients. The proximal portion was located in gastrohepatic ligament and its distal portion was located in front of esophageal hiatus. In a cadaver dissection, the proximal portion ascends along ligamentum venosum and distal portion courses along superior aspect of left hemi diaphragm in front of esophagus. Conclusion: The LIPA rarely arises from left hepatic or left gastric artery. The proximal portion was located in gastrohepatic ligament and the distal portion runs in front of the esophageal hiatus.