Inferior phrenic arteries and their branches, their anatomy and possible clinical importance: An experimental cadaver study

Abstract

Background: Transcatheter arterial chemoembolization is a common treatment for patients with inoperable hepatocellular carcinoma. If the carcinoma is ad- vanced or the main arterial supply, the hepatic artery, isoccluded, extrahepatic collateral arteries may develop.Both, right and left inferior phrenic arteries (RIPA andLIPA) are the most frequent and important among thesecollaterals. However, the topographic anatomy of thesearteries has not been described in detail in anatomytextbooks, atlases and most previous reports. Aims: To investigate the anatomy and branching patterns of RIPA and LIPA on cadavers and compare ourresults with the literature. Study Design: Descriptive study. Methods: We bilaterally dissected 24 male and 2 femalecadavers aged between 49 and 88 years for this study. Results: The RIPA and LIPA originated as a commontrunk in 5 cadavers. The RIPA originated from the abdominal aorta in 13 sides, the renal artery in 2 sides,the coeliac trunk in 1 side and the left gastric artery in 1side. The LIPA originated from the abdominal aorta in9 sides and the coeliac trunk in 6 sides. In 6 cadavers,the ascending and posterior branches of the LIPA haddifferent sources of origin.Conclusion: As both the RIPA and LIPA represent thehalf of all extrahepatic arterial collaterals to hepatocellular carcinomas, their anatomy gains importance not onlyfor anatomists but interventional radiologists as well.