open access

Vol 82, No 3 (2023)
Review article
Submitted: 2022-01-31
Accepted: 2022-04-29
Published online: 2022-06-22
Get Citation

Clinical significance of morphological variations of the inferior phrenic arteries

W. Marcinkowska1, M. Malicki1, P. Karauda1, R. S. Tubbs234567, N. Zielinska1, Ł. Olewnik1
·
Pubmed: 35754187
·
Folia Morphol 2023;82(3):467-477.
Affiliations
  1. Department of Anatomical Dissection and Donation, Medical University of Lodz, Poland
  2. Department of Neurosurgery, Tulane University School of Medicine, New Orleans, LA, United States
  3. Department of Neurology, Tulane University School of Medicine, New Orleans, LA, United States
  4. Department of Surgery, Tulane University School of Medicine, New Orleans, LA, United States
  5. Department of Structural and Cellular Biology, Tulane University School of Medicine, New Orleans, LA, United States
  6. Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, LA, United States
  7. Department of Anatomical Sciences, St. George’s University, Grenada, West Indies

open access

Vol 82, No 3 (2023)
REVIEW ARTICLES
Submitted: 2022-01-31
Accepted: 2022-04-29
Published online: 2022-06-22

Abstract

The rapid development of sciences such as genetics and molecular biology offers
hope that better therapeutic methods can be developed and diagnosis and
treatment made more effective. However, we must not forget that the basis for
understanding the complex mechanisms of diseases and associated symptoms is
knowledge of the relevant location and correlation among organs. In the present
study, we focus on the clinical significance of the inferior phrenic artery. The diaphragm
is a muscular structure that separates the abdominal and chest cavities.
Thanks to this position, the inferior phrenic artery is much more significant than
formerly assumed. A rich network of collaterals makes this vessel important in
the development of neoplasms and metastases. Knowledge of anatomical variants
of the inferior phrenic artery is also crucial for radiological procedures such
as embolisation. The main aim of this study is to review the involvement of the
inferior phrenic artery in physiological and pathophysiological processes. This
work has value for all practicing doctors, especially radiologists and surgeons.

Abstract

The rapid development of sciences such as genetics and molecular biology offers
hope that better therapeutic methods can be developed and diagnosis and
treatment made more effective. However, we must not forget that the basis for
understanding the complex mechanisms of diseases and associated symptoms is
knowledge of the relevant location and correlation among organs. In the present
study, we focus on the clinical significance of the inferior phrenic artery. The diaphragm
is a muscular structure that separates the abdominal and chest cavities.
Thanks to this position, the inferior phrenic artery is much more significant than
formerly assumed. A rich network of collaterals makes this vessel important in
the development of neoplasms and metastases. Knowledge of anatomical variants
of the inferior phrenic artery is also crucial for radiological procedures such
as embolisation. The main aim of this study is to review the involvement of the
inferior phrenic artery in physiological and pathophysiological processes. This
work has value for all practicing doctors, especially radiologists and surgeons.

Get Citation

Keywords

inferior phrenic artery, diaphragm vascularisation, morphological variations, accessory inferior artery, hepatocellular carcinoma, pseudoaneurysm, embolisation

About this article
Title

Clinical significance of morphological variations of the inferior phrenic arteries

Journal

Folia Morphologica

Issue

Vol 82, No 3 (2023)

Article type

Review article

Pages

467-477

Published online

2022-06-22

Page views

1155

Article views/downloads

705

DOI

10.5603/FM.a2022.0061

Pubmed

35754187

Bibliographic record

Folia Morphol 2023;82(3):467-477.

Keywords

inferior phrenic artery
diaphragm vascularisation
morphological variations
accessory inferior artery
hepatocellular carcinoma
pseudoaneurysm
embolisation

Authors

W. Marcinkowska
M. Malicki
P. Karauda
R. S. Tubbs
N. Zielinska
Ł. Olewnik

References (39)
  1. Ahn HJ, Lee JW, Kim KD, et al. Phrenic arterial injury presenting as delayed hemothorax complicating simple rib fracture. J Korean Med Sci. 2016; 31(4): 641–643.
  2. Aslaner R, Pekcevik Y, Sahin H, et al. Variations in the origin of inferior phrenic arteries and their relationship to celiac axis variations on CT angiography. Korean J Radiol. 2017; 18(2): 336–344.
  3. Basile A, Tsetis D, Montineri A, et al. MDCT anatomic assessment of right inferior phrenic artery origin related to potential supply to hepatocellular carcinoma and its embolization. Cardiovasc Intervent Radiol. 2008; 31(2): 349–358.
  4. Calin ML, Arevalo G, Harris K, et al. Large sized left inferior phrenic artery and parahiatal type of diaphragmatic hernia generating confusion during robotic surgical repair. J Laparoendosc Adv Surg Tech A. 2017; 27(3): 283–287.
  5. Downey R. Anatomy of the normal diaphragm. Thorac Surg Clin. 2011; 21(2): 273–279, ix.
  6. Greig HW, Anson BJ, Coleman SS. The inferior phrenic artery; types of origin in 850 body-halves and diaphragmatic relationship. Q Bull Northwest Univ Med Sch. 1951; 25(4): 345–350.
  7. Gürses İA, Gayretli Ö, Kale A, et al. Inferior phrenic arteries and their branches, their anatomy and possible clinical importance: an experimental cadaver study. Balkan Med J. 2015; 32(2): 189–195.
  8. Gwon DIl, Ko GY, Yoon HK, et al. Inferior phrenic artery: anatomy, variations, pathologic conditions, and interventional management. Radiographics. 2007; 27(3): 687–705.
  9. Hagiwara A, Akai H, Kosaka T, et al. A dorsal pancreatic artery originating from the right inferior phrenic artery. J Vasc Interv Radiol. 2016; 27(1): 143–145.
  10. Handa A, Dhooria S, Sehgal IS, et al. Primary cavitary sarcoidosis: A case report, systematic review, and proposal of new diagnostic criteria. Lung India. 2018; 35(1): 41–46.
  11. Heymann G, Shin DS, Johnson GE. Accessory left gastric artery arising from inferior phrenic artery: angiographic findings in 5 patients. J Vasc Interv Radiol. 2019; 30(10): 1687–1689.
  12. Insko EK, Carpenter JP. Magnetic resonance angiography. Semin Vasc Surg. 2004; 17(2): 83–101.
  13. Ito K, Kim MJ, Mitchell DG, et al. Inferior phrenic arteries: depiction with thin-section three-dimensional contrast-enhanced dynamic MR imaging with fat suppression. J Magn Reson Imaging. 2001; 13(2): 201–206, doi: 10.1002/1522-2586(200102)13:2<201::aid-jmri1030>3.0.co;2-l.
  14. Ivancevic MK, Geerts L, Weadock WJ, et al. Technical principles of MR angiography methods. Magn Reson Imaging Clin N Am. 2009; 17(1): 1–11.
  15. Kang PS, Spain JW. Multidetector CT angiography of the abdomen. Radiol Clin North Am. 2005; 43(6): 963–976, vii.
  16. Kim HC, Chung JW, An S, et al. Left inferior phrenic artery feeding hepatocellular carcinoma: angiographic anatomy using C-arm CT. Am J Roentgenol. 2009; 193(4): W288–W294.
  17. Kimura S, Okazaki M, Higashihara H, et al. Analysis of the origin of the right inferior phrenic artery in 178 patients with hepatocellular carcinoma treated by chemoembolization via the right inferior phrenic artery. Acta Radiol. 2007; 48(7): 728–733.
  18. Kumamaru KK, Hoppel BE, Mather RT, et al. CT angiography: current technology and clinical use. Radiol Clin North Am. 2010; 48(2): 213–235, vii.
  19. Lee JW, Kim S, Kim CW, et al. Massive hemoperitoneum due to ruptured inferior phrenic artery pseudoaneurysm after blunt trauma. Emerg Radiol. 2006; 13(3): 147–149.
  20. Lell MM, Anders K, Uder M, et al. New techniques in CT angiography. Radiographics. 2006; 26 (Suppl 1): S45–S62.
  21. Loukas M, Hullett J, Wagner T. Clinical anatomy of the inferior phrenic artery. Clin Anat. 2005; 18(5): 357–365.
  22. Mitty HA. Embryology, anatomy, and anomalies of the adrenal gland. Semin Roentgenol. 1988; 23(4): 271–279.
  23. Moustafa AS, Abdel Aal AK, Ertel N, et al. Chemoembolization of hepatocellular carcinoma with extrahepatic collateral blood supply: anatomic and technical considerations. Radiographics. 2017; 37(3): 963–977.
  24. Muhs BE, Verhagen HJM, Huddle MG, et al. Theory, technique, and practice of magnetic resonance angiography. Vascular. 2007; 15(6): 376–383.
  25. Nagar N, Dubale N, Jagadeesh R, et al. Unusual locations of pseudo aneurysms as a sequel of chronic pancreatitis. J Interv Gastroenterol. 2011; 1(1): 28–32.
  26. Nonent M, Thouveny F, Simons P, et al. Iodixanol in multidetector-row computed tomography angiography (MDCTA): diagnostic accuracy for abdominal aorta and abdominal aortic major-branch diseases using four-, eight- and 16-detector-row CT scanners. Acta Radiol. 2007; 48(1): 48–58.
  27. Northrop CH, Studley MA, Smith GR. Hemorrhage from the gastroesophageal junction. A cryptic angiographic diagnosis. Radiology. 1975; 117(3 Pt 1): 531–532.
  28. Núñez DB, Torres-León M, Múnera F. Vascular injuries of the neck and thoracic inlet: helical CT-angiographic correlation. Radiographics. 2004; 24(4): 1087–1100.
  29. Ozbulbul NI, Yurdakul M, Tola M, et al. Can multidetector row CT visualize the right and left inferior phrenic artery in a population without disease of the liver? Surg Radiol Anat. 2009; 31(9): 681–685.
  30. Rossi UG, Ierardi AM, Cariati M. Diaphragmatic rupture with inferior phrenic artery bleeding caused by cardiopulmonary resuscitation. Clin Exp Emerg Med. 2020; 7(3): 238–240.
  31. Saba L, Mallarini G. Multidetector row CT angiography in the evaluation of the hepatic artery and its anatomical variants. Clin Radiol. 2008; 63(3): 312–321.
  32. Salem JF, Haydar A, Hallal A. Inferior phrenic artery pseudoaneurysm complicating drug-induced acute pancreatitis. BMJ Case Rep. 2014; 2014.
  33. Schumpelick V, Steinau G, Schlüper I, et al. Surgical embryology and anatomy of the diaphragm with surgical applications. Surg Clin North Am. 2000; 80(1): 213–239, xi.
  34. Smith DC, Kitching GB. Angiographic demonstration of esophagogastric bleeding from the inferior phrenic artery. Radiology. 1977; 125(3): 613–614.
  35. So YH, Chung JW, Yin Y, et al. The right inferior phrenic artery: origin and proximal anatomy on digital subtraction angiography and thin-section helical computed tomography. J Vasc Interv Radiol. 2009; 20(9): 1164–1171.
  36. Sperryn PN. Blood. Br J Sports Med. 1989; 23(2): 129–131.
  37. Szewczyk B, Karauda P, Olewnik Ł, et al. Types of inferior phrenic arteries: a new point of view based on a cadaveric study. Folia Morphol. 2021; 80(3): 567–574.
  38. Zeng R, Yao Z, Chen Y, et al. Variant arterial supply to the lesser curvature of the stomach and duodenum from double inferior phrenic arteries. Surg Radiol Anat. 2015; 37(7): 867–869.
  39. Zhu LZ, Yang RJ, Zhu Xu. Role of inferior phrenic artery in the interventional treatment of lung metastases tumor: A report of 11 cases. J Cancer Res Ther. 2018; 14(1): 61–67.

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