Inferior phrenic arteries and their branches, their anatomy and possible clinical importance: An experimental cadaver study

Inferior phrenic arteries and their branches, their anatomy and possible clinical importance: An experimental cadaver study

Background: Transcatheter arterial chemoembolization is a common treatment for patients with inoperable hepatocellular carcinoma. If the carcinoma is ad- vanced or the main arterial supply, the hepatic artery, isoccluded, extrahepatic collateral arteries may develop.Both, right and left inferior phrenic arteries (RIPA andLIPA) are the most frequent and important among thesecollaterals. However, the topographic anatomy of thesearteries has not been described in detail in anatomytextbooks, atlases and most previous reports. Aims: To investigate the anatomy and branching patterns of RIPA and LIPA on cadavers and compare ourresults with the literature. Study Design: Descriptive study. Methods: We bilaterally dissected 24 male and 2 femalecadavers aged between 49 and 88 years for this study. Results: The RIPA and LIPA originated as a commontrunk in 5 cadavers. The RIPA originated from the abdominal aorta in 13 sides, the renal artery in 2 sides,the coeliac trunk in 1 side and the left gastric artery in 1side. The LIPA originated from the abdominal aorta in9 sides and the coeliac trunk in 6 sides. In 6 cadavers,the ascending and posterior branches of the LIPA haddifferent sources of origin.Conclusion: As both the RIPA and LIPA represent thehalf of all extrahepatic arterial collaterals to hepatocellular carcinomas, their anatomy gains importance not onlyfor anatomists but interventional radiologists as well.

___

  • 1. Yamada R, Sato M, Kawabata M, Nakatsuka H, Nakamura K, Takashima S. Hepatic artery embolization in 120 patients with un- resectable hepatoma. Radiology 1983;148:397-401. [CrossRef]
  • 2. Chuang VP, Wallace S. Hepatic artery embolization in the treatment of hepatic neoplasms. Radiology 1981;140:51-8. [CrossRef]
  • 3. Duprat G, Charnsangavej C, Wallace S, Carrasco CH. Inferior phrenic artery embolization in the treatment of hepatic neo- plasms. Acta Radiol 1988;29:427-9. [CrossRef]
  • 4. Kim HC, Chung JW, An S, Seong NK, Jae HJ, Cho BH, et al. Left phrenic artery feeding hepatocellular carcinoma: an- giographic anatomy using C-Arm CT. AJR Am J Roentgenol 2009;193:W288-W294. [CrossRef]
  • 5. Kim HC, Chung JW, Lee W, Jae HJ, Cho BH, Park JH. Recog- nizing extrahepatic collateral vessels that supply hepatocellular carcinoma to avoid complications of transcathater arterial che- moembolization. Radiographics 2005;25:S25-39. [CrossRef]
  • 6. Miyayama S, Matsui O, Taki K, Minami T, Ryu Y, Ito C, et al. Extrahepatic blood supply to hepatocellular carcinoma: angio- graphic demonstration and transcathater arterial chemoemboli- zation. Cardiovasc Intervent Radiol 2006;29:39-48. [CrossRef]
  • 7. Chung JW, Park JH, Han JK, Choi BI, Kim TK, Han MC. Trans- cathater oily chemoembolization of the inferior phrenic artery in hepatocellular carcinoma: the safety and potential therapeutic role. J Vasc Interv Radiol 1998;9:495-500. [CrossRef]
  • 8. Kahn PC. Selective angiography of the inferior phrenic arteries. Radiology 1967;88:1-8. [CrossRef]
  • 9. Northrop CH, Studley MA, Smith GR. Hemorrhage from the gastroesophageal junction. A cryptic angiographic diagnosis. Radiology 1975;117:531-2. [CrossRef]
  • 10. Smith DC, Kitching GB. Angiographic demonstration of esoph- agogastric bleeding from the inferior phrenic artery. Radiology 1977;125:613-4. [CrossRef]
  • 11. Carsen GM, Casarella WJ, Spiegel RM. Transcatheter emboli- zation for treatment of Mallory-Weiss tears of the esophagogas- tric junction. Radiology 1978;128:309-13. [CrossRef]
  • 12. Loukas M, Hullett J, Wagner T. Clinical anatomy of the inferior phrenic artery. Clin Anat 2005;18:357-65. [CrossRef]
  • 13. Adachi B. Das arterien system der Japaner, Band 2. Kyoto. Kei- serlich-Japanischen Universitat 1928; pp.14-16.
  • 14. Pick JW, Anson BJ. The infeior phrenic artery: origin and supra- renal branches. Anat Rec 1940;78:413-27. [CrossRef]
  • 15. Greig HW, Anson BJ, Coleman SS. The inferior phrenic artery: types of origin in 850 body-halves and diaphragmatic relation- ship. Q Bull Northwest Univ Med Sch 1951;25:345-50.
  • 16. Lippert H, Pabst R. Aortic arch. In: Arterial Variations in Man: Classification and Frequency. Munich, Germany: JF Bergmann- Verlag 1985;p.24 [CrossRef]
  • 17. So YH, Chung JW, Yin Y, Jae HJ, Jeon UB, Cho BH, et al. The right phrenic artery: origin and proximal anatomy on digital sub- straction angiography and thin-section helical computed tomog- raphy. J Vasc Interv Radiol 2009;20:1164-71. [CrossRef]
  • 18. Basile A, Tsetis D, Montineri A, Puelo S, Saluzzo CM, Runza G, et al. MDCT anatomic assessment of right inferior phrenic artery origin related to potential supply to hepatocellulat carcinoma and its embo- lization. Cardiovasc Intervent Radiol 2008;31:349-58. [CrossRef]
  • 19. Kim HC, Chung JW, Kim WH, An S, Seong NJ, Jae HJ, et al. Chemoembolization of the left inferior phrenic artery in patients with hepatocellular carcinoma: 9-year single-center experience. AJR Am J Roentgenol 2010;194:1124-30. [CrossRef]
  • 20. Piao DX, Ohtsuka A, Murakami T. Typology of abdominal arteries, with special reference to inferior phrenic arteries and their esopha- geal branches. Cardiovasc Intervent Radiol 1998;52:189-96.
  • 21. Gwon DI, Ko GY, Yoon HK, Sung KB, Lee JM, Ryu SJ, et al. In- ferior phrenic artery: anatomy, variations, pathologic conditions, and interventional management. Radiographics 2007;27:687- 705. [CrossRef]
  • 22. Ozbulbul NI, Yurdakul M, Tola M. Does the right inferior phren- ic artery have a supplying role in liver cirrhosis without hepa- tocellular carcinoma? A 64-slice CT study. Diagn Interv Radiol 2011;17:239-42.
  • 23. Tanaka R, Ibukuro K, Akita K. The left inferior phrenic artery arising from left hepatic artery or left gastric artery: radiological and anatomical correlation in clinical cases and cadaver dissec- tion. 2008;33:328-33.
  • 24. Hieda M, Toyota N, Kakiwaza H, Ishikawa M, Horiguchi J, Ito K. The anterior branch of the left inferior phrenic artery: an angiographic and CT study. Cardiovasc Intervent Radiol 2009;32:250-4. [CrossRef]
  • 25. Miyayama S, Yamashiro M, Yoshie Y, Okuda M, Nakashima Y, Ikeno H, et al. Inferior phrenic arteries: angiographic anat- omy, variations, and catheterization tecniques for transcath- eter arterial chemoembolization. Jpn J Radiol 2010;28:502- 11. [CrossRef]
  • 26. Shin SW, Do YS, Choo SW, Lieu WC, Cho SK, Park KB, et al. Diaphragmatic weakness after transcatheter arterial chemoem- bolization of inferior phrenic artery for treatment of hepatocel- lular carcinoma. Radiology 2006;241:581-8. [CrossRef]
  • 27. Lee DH, Chung JW, Kim HC, Jae HJ, Yoon CJ, Kang SG, et al. Development of diaphragmatic weakness after transcath- eter arterial chemoembolization of the right inferior phrenic artery: frequency and determinent factors. J Vasc Interv Radiol 2009;20:484-9. [CrossRef]
  • 28. Chung JW, Park JH, Han JK, Choi BI, Han MC, Lee HS, et al. Hepatic tumors: predisposing factors for complications of trans- catheter oily chemoembolization. Radiology 1996;198:33-40. [CrossRef]
  • 29. Felix W. The mesonephric arteries. In: Kiebel F and Mall FP (eds). Manual of human embryology. Volume 2. Philadelphia: J. B. Lippincott Company 1912;pp.820-5.
  • 30. Isogai S, Horiguchi M, Hitomi J. The para-aortic ridge plays a key role in the formation of renal, adrenal and gonadal vascular systems. J Anat 2010;216:656-70. [CrossRef]
Balkan Medical Journal-Cover
  • ISSN: 2146-3123
  • Başlangıç: 2015
  • Yayıncı: Erkan Mor
Sayıdaki Diğer Makaleler

Detection of methicillin resistance and various virulence factors in staphylococcus aureus strains isolated from nasal carriers

Uğur ARSLAN, Hatice DAĞI TÜRK, Duygu FINDIK, Gamze DEMİREL

New Predictive parameters of bell's palsy: Neutrophil to lymphocyte ratio and platelet to lymphocyte ratio

Mehmet Ali ÇETİN, Sabri KÖSEOĞLU, Serdar ENSARİ, Aykut İKİNCİOĞULLARI, Kürşat Murat ÖZCAN, Doğan ATAN, Hüseyin DER

Aripiprazole induced acute transient bilateral myopia: A case report

Mutlu ACAR, Kadir ÖZDEL, Hasan KARADAĞ

Association of serum uric acid with family history of coronary artery disease in a pakistani population

Tahir IQBAL, Sabir HUSSAİN

A comparison of the effects of different types of laryngoscope on the cervical motions: randomized clinical trial

Ali YILMAZ, Alkin ÇOLAK, Elif ÇOPUROĞLU, Sevtap ŞAHİN HEKİMOĞLU, Nesrin TURAN

The reflection of plication surgery for diaphragm eventration to respiratory function test

Ertan AYDIN, Nurettin KARAOĞLANOĞLU, Ülkü YAZICI, Serdar ÖZKAN

Detection of human bocavirus dna by multiplex pcr analysis: Postmortem case report

Taner DAŞ, Neval ELGÖRMÜŞ, Gözde ŞİRİN, Nihan ZİYADE

Successful treatment of refractory gastrointestinal bleeding by systemic (oral) ankaferd blood stopper in a patient with glanzmann thrombasthenia

Sibel HACIOĞLU KABUKÇU, Ali KESKİN, İsmail SARI, Mehmet Hilmi DOĞU

Fetal oropharyngeal and neck tumors: Determination of the need for ex-utero intrapartum treatment procedure

Ümran GÜLEÇ KÜÇÜKGÖZ, Selim BÜYÜKKURT, Hacer YAPICIOĞLU, Serdar İSKİT, Süleyman Cansun DEMİR, Fatma ÖZGÜNEN TUNCAY, İsmail Cüneyt EVRÜKE

The Effects of sugammadex on progesterone levels in pregnant rats

Atilla EROL, Aybars TAVLAN, Alper KILIÇASLAN, Ahmet TOPAL, Sema UZUN TUNCER, Tayfun ET