Vol 76, No 3 (2017)
Original article
Published online: 2017-03-09
Common and separate origins of the left and right inferior phrenic artery with a review of the literature
Abstract
In a 94-year-old male cadaver, upon which routine dissection was being conducted, a rare variation was found in the gastrophrenic trunk (GPT), the common trunk of the left gastric artery (LGA), right inferior phrenic artery (RIPA), and left inferior phrenic artery (LIPA); the GPT arises from the abdominal aorta. A hepatosplenic trunk accompanied the variation. In this variation, the RIPA first branched from the GPT and then to the LIPA and LGA. Variations in the common trunk of the LIPA and RIPA in the GPT are common, but to our knowledge, a variation (separate inferior phrenic artery in the GPT) similar to our findings has not been previously reported. We discuss the incidence and developmental and clinical significance of this variation with a detailed review of the literature. Knowledge of such a case has important clinical significance for invasive and non-invasive arterial procedures. Therefore, different variations concerning the LGA and inferior phrenic artery should be considered during surgical and non-surgical evaluations.
Keywords: separate left gastric arteryinferior phrenic arterygastrophrenic trunkvascular developmentcadaver
References
- Adachi B. Das arterien system der Japaner, Band 2. Keiserlich-Japanischen Universitat, Kyoto 1928: 14–16.
- 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.
- Bergman RA, Afifi AK, Miyauchi R (2012) Illustrated Encyclopedia of Human Anatomic Variation: Opus II: Cardiovascular System: Arteries: Abdomen. Inferior Phrenic Artery. URL. http://www.anatomyatlases.org/AnatomicVariants/Cardiovascular/Text/Arteries/InferiorPhrenic.shtml.
- Ciçekcibaşi AE, Uysal II, Seker M, et al. A rare variation of the coeliac trunk. Ann Anat. 2005; 187(4): 387–391.
- Gokan T, Hashimoto T, Matsui S, et al. Helical CT demonstration of dilated right inferior phrenic arteries as extrahepatic collateral arteries of hepatocellular carcinomas. J Comput Assist Tomogr. 2001; 25(1): 68–73.
- 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.
- Gurses I, Gayretli O, Kale A, et al. Inferior phrenic arteries and their branches, their anatomy and possible clinical importance: an experimental cadaver study. Balkan Medical J. 2015; 32(2): 189–195.
- Hirai Y, Yamaki K, Saga T, et al. An anomalous case of the hepato-spleno-mesenteric and the gastro-phrenic trunks independently arising from the abdominal aorta. Kurume Med J. 2000; 47(2): 189–192.
- Hirai Y, Yamaki K, Saga T, et al. Two anomalous cases of the hepato-mesenteric and the gastro-splenic trunks independently arising from the abdominal aorta. Kurume Med J. 2000; 47(3): 249–252.
- Kahn PC. Selective angiography of the inferior phrenic arteries. Radiology. 1967; 88(1): 1–8.
- Kim HC, Chung JW, Lee W, et al. Recognizing extrahepatic collateral vessels that supply hepatocellular carcinoma to avoid complications of transcatheter arterial chemoembolization. Radiographics. 2005; 25 (Suppl 1): S25–S39.
- Kim HC, Chung JW, An S, et al. Left inferior phrenic artery feeding hepatocellular carcinoma: angiographic anatomy using C-arm CT. AJR Am J Roentgenol. 2009; 193(4): W288–W294.
- Kim HC, Chung JW, Kim WH, 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(4): 1124–1130.
- Lee HS, Kim KMo, Yoon JH, et al. Therapeutic efficacy of transcatheter arterial chemoembolization as compared with hepatic resection in hepatocellular carcinoma patients with compensated liver function in a hepatitis B virus-endemic area: a prospective cohort study. J Clin Oncol. 2002; 20(22): 4459–4465.
- Loukas M, Hullett J, Wagner T. Clinical anatomy of the inferior phrenic artery. Clin Anat. 2005; 18(5): 357–365.
- Matusz P, Loukas M, Iacob N, et al. Common stem origin of left gastric, right and left inferior phrenic arteries, in association with a hepatosplenomesenteric trunk, independently arising from the abdominal aorta: case report using MDCT angiography. Clin Anat. 2013; 26(8): 980–983.
- Miclaus GD, Matusz P, Loukas M, et al. Rare case of the trunk of the inferior phrenic arteries originating from a common stem with a superior additional left renal artery from the abdominal aorta. Clin Anat. 2012; 25(8): 979–982.
- Morita M. Reports and conception of three anomalous cases on the area of the celiac and the superior mesenteric arteries (in Japanese). Igaku Kenkyu. 1935; 9: 159–172.
- Nayak S. Common celiaco-mesenterico-phrenic trunk and renal vascular variations. Saudi Med J. 2006; 27(12): 1894–1896.
- 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.
- Ozbülbül NI, Yurdakul M, Tola M. Does the right inferior phrenic artery have a supplying role in liver cirrhosis without hepatocellular carcinoma? A 64-slice CT study. Diagn Interv Radiol. 2011; 17(3): 239–242.
- Piao DX, Ohtsuka A, Murakami T. Typology of abdominal arteries, with special reference to inferior phrenic arteries and their esophageal branches. Acta Med Okayama. 1998; 52(4): 189–196.
- Pick J, Anson B. The inferior phrenic artery: Origin and suprarenal branches. Anat Rec. 1940; 78(4): 413–427.
- Saeed M, Murshid KR, Rufai AA, et al. Coexistence of multiple anomalies in the celiac-mesenteric arterial system. Clin Anat. 2003; 16(1): 30–36.
- So YHo, 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.
- Tandler J. Zur Entwicklungsgeschichte der menschlichen Darmarterien. Anat Hefte 23:189–209. 1904: 475–499.
- Tanabe N, Iwasaki T, Chida N, et al. Hepatocellular carcinomas supplied by inferior phrenic arteries. Acta Radiol. 1998; 39(4): 443–446.
- Topaz On, Topaz A, Polkampally PR, et al. Origin of a common trunk for the inferior phrenic arteries from the right renal artery: a new anatomic vascular variant with clinical implications. Cardiovasc Revasc Med. 2010; 11(1): 57–62.
- Yi SQ, Li J, Terayama H, et al. A rare case of inferior mesenteric artery arising from the superior mesenteric artery, with a review of the review of the literature. Surg Radiol Anat. 2008; 30(2): 159–165.
- Zebrowski W, Augustyniak E, Zajac S. Variation of origin and branches of the inferior mesenteric artery and its anastomoses. Folia Morphol. 1971; 30: 510–517.
