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

Binit Sureka1, Mahesh Kumar Mittal1, Aliza Mittal2

  • 1Department of Radiodiagnosis, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.

The Indian Journal of Radiology & Imaging
|December 19, 2013
PubMed

Insights

This study found that 5.5% of patients exhibit variations in celiac axis and hepatic artery anatomy. Computed tomography angiography (CTA) is a safe and accurate method for evaluating these arterial variations.

Area of Science:

  • Radiology
  • Vascular Anatomy
  • Medical Imaging

Background:

  • The celiac axis and its branches, including the common hepatic artery (CHA), right hepatic artery (RHA), left hepatic artery (LHA), middle hepatic artery (MHA), and gastroduodenal artery (GDA), exhibit significant anatomical variations.
  • Accurate pre-operative knowledge of these variations is crucial for surgical planning, particularly in liver transplantation and oncologic resections.

Purpose of the Study:

  • To delineate the spectrum of anatomical variations of the celiac axis, CHA, RHA, LHA, MHA, and GDA using spiral computed tomography (CT).

Main Methods:

  • A retrospective analysis of 600 Multidetector CT (MDCT) abdominal angiography scans was conducted.
  • Standardized definitions for anatomical variations were applied.
  • The aortic origin, course, and branching patterns of the celiac axis and its hepatic and gastroduodenal branches were meticulously analyzed.

Main Results:

  • Normal celiac axis anatomy was observed in 94.5% of patients, with variations identified in 5.5%.
  • Common hepatic artery (CHA) originated from the celiac axis in 95.83% of cases, with variations noted in 8 patients.
  • Variations in the origin of the RHA (15.16% replaced, 5.16% accessory) and LHA (10.8% replaced, 7.6% accessory) were common. The MHA showed variable origins, including from the RHA (41.3%) and LHA (27.83%).
  • Gastroduodenal artery (GDA) originated from the CHA in 97.6% of patients.

Conclusions:

  • Computed tomography (CT) angiography is a highly sensitive, accurate, and safe imaging modality for the comprehensive evaluation of celiac axis and hepatic artery anatomy and its variants.
  • Understanding these arterial variations is essential for interventional radiologists and surgeons to minimize complications and optimize treatment strategies.
Abstract

Keywords:
Abdominal angiographyaccessoryambiguous celiac axisceliac axiscommon hepatic arteryreplaced hepatic artery

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