Quantitative clinical anatomy of the pancreatic arteries studied by selective celiac angiography

The angiographic visualization of the pancreatic arteries, their numerical variations, origins, course and anastomoses, as well as their mean diameter by age-group (20-40, 41-60, greater than 60 years) have been quantitatively investigated by selective celiac angiography in 72 patients without pancreatic disease. Visualization of the various arteries was achieved in a high percentage of cases except for the inferior pancreaticoduodenal arches, due to undervaluation of this vessel by celiac angiography. Confirmation of the great variability of the origin and anastomoses of the dorsal and transverse pancreatic arteries was obtained and possible embryologic reasons and clinical implications of this fact are discussed. Furthermore, a high percentage of multiple (quadruple or more) pancreatica magna and caudae pancreatis arteries has been observed and a functional role of this peculiar arrangement is suggested. Finally, no statistically significant differences were found in the diameter of any artery due to increasing age, probably reflecting maintained neural perivascular control of the pancreatic vessels in the elderly. Satisfactory sensitivity of the angiographic method has been found with respect to the evaluation of visualization and anastomoses of the pancreatic arteries in vivo.