Variants of hepatic arterial supply in a Caribbean population: a computed tomography based study
P B Johnson1, S O Cawich, P Roberts
1Section of Radiology, Department of Surgery, Radiology, Anaesthetics and Intensive Care, University of the West Indies, Jamaica. peter.johnson03@uwimona.edu.jm
Insights
This study found that while most Caribbean patients have standard hepatic artery anatomy, there are significant differences in variations compared to international data. Awareness of these unique vascular patterns is crucial for safe medical procedures.
Area of Science:
- Vascular anatomy
- Radiology
- Hepatobiliary imaging
Background:
- Hepatic arterial variations are common and can impact surgical and interventional procedures.
- Understanding regional variations is essential for accurate diagnosis and treatment planning.
Purpose of the Study:
- To document the spectrum of hepatic arterial variants in a Caribbean population.
- To compare these findings with international literature.
Main Methods:
- Retrospective review of 309 computed tomography (CT) angiographic studies.
- Independent analysis by two radiologists using Michels' classification system.
Main Results:
- Michels' type 1 anatomy was most common (63.4%).
- A significantly higher incidence of type 2 variations (20.4%) was observed compared to international data.
- Lower incidences of types 3, 6, and 9 were noted, with one unclassified variant.
Conclusions:
- The distribution of hepatic arterial variants in the Caribbean differs from North American and European populations.
- Hepatobiliary surgeons and interventional radiologists in the Caribbean must be aware of these specific anatomical differences.
- Recognizing these variants is vital to minimize complications during invasive procedures.
Aim:
To evaluate the spectrum of hepatic arterial variants in unselected patients undergoing computed tomography (CT) of the abdomen at the main regional referral centre in the northern Anglophone Caribbean.
Materials And Methods:
Two radiologists independently reviewed 309 CT angiographic studies performed over 2 years between 1 July 2010 and 30 June 2012 at a regional hepatobiliary referral centre for the Northern Caribbean. The anatomical variations were described according to a conventional classification proposed by Michels et al.
Results:
In this Caribbean population, the majority of patients had conventional Michels' type 1 vascular anatomy (63.4%). However, a statistically significantly greater incidence of Michels' type 2 variations (20.4%) were found than that reported in the international literature and a lower incidence of type 3 (5.2%), type 6 (0.6%), and type 9 (0) patterns than previously reported. One case with variations not previously described in this classification was also encountered.
Conclusion:
Although 63.4% of persons in a Caribbean population have conventional vascular anatomy, the distribution of anatomical variants is quite different to that seen in North American and European centres. Interventional radiologists and hepatobiliary surgeons practicing in the Caribbean must be cognizant of these differences in order to minimize morbidity and mortality during invasive procedures.
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