ISSN: 1899-0967
Polish Journal of Radiology
Established by prof. Zygmunt Grudziński in 1926 Sun
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1/2022
vol. 87
 
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Cardiovascular radiology
abstract:
Original paper

Newly proposed classification of celiac artery variations based on embryology and correlation with computed tomography angiography

Dillibabu Ethiraj
1
,
Srinivasan Kalyanasundaram
2
,
Venkatraman Indiran
3
,
Baskaran Varadan
2
,
Komalavalli Subbiah
2
,
Sripriya Srinivas
4
,
Rajesh Rajalingam
5
,
Mettu Srinivas Reddy
6
,
Poonam Kharb Janghu
7
,
Immanuel Judah Pandiaraj
3
,
Niranjan Dhanaji Kanase
3

1.
Department of Radiodiagnosis, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
2.
Department of Radiodiagnosis, Dr Rela Institute and Medical Centre, Chromepet, Chennai, Tamilnadu, India
3.
Department of Radiodiagnosis, Sree Balaji Medical College and Hospital, Chromepet, Chennai, India
4.
Department of Radiology, Gleneagles Global Hospital & Health City, Cheran Nagar, Perumbakkam, Chennai, India
5.
Department of Liver Surgery and Transplantation, Dr Rela Institute and Medical Centre, Chromepet, Chennai, Tamilnadu, India
6.
Gleneagles Global Hospital & Health City, Cheran Nagar, Perumbakkam, Chennai, India
7.
Department of Human Anatomy, ITS Dental College, Muradnagar, Ghaziabad, Uttar Pradesh, India
© Pol J Radiol 2022; 87: e563-e573
Online publish date: 2022/10/18
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Introduction
We studied the prevalence of celiac trunk and its anatomical variations on diagnostic computed tomography angiography (CTA) studies and have proposed a new classification to define the celiac artery (CA) variations based on embryology.

Material and methods
We retrospectively assessed the celiac trunk variations in 1113 patients who came to our department for diagnostic CTA for liver and renal donor workup. The patient data were acquired from the Picture Archiving and Communication System of our institutions. We analysed the celiac trunk’s origin and branching pattern, including the superior mesenteric artery (SMA) and inferior phrenic artery (IPA).

Results
We evaluated the CTA studies of 1050 patients. A normal trifurcation pattern, the most common type, was observed in 39% of cases. Variation with CA + left IPA was the most common subtype. Other variations noted in the study and their incidences are listed in the table below. We attempted to propose a new classification based on embryo­logy, which comprises 6 main types and their subtypes. We also analysed previous studies from the literature, including cadaveric, post-mortem, CTA, and digital subtraction angiography studies and compared them with the present study.

Conclusions
Because variations of CA classifications reported to date do not encompass all CA branching pattern variants, we have proposed a new classification that incorporates most of the variants. We reiterate the clinical importance of anatomical variants of CA, IPA, and SMA in surgical and interventional radiology procedures.

keywords:

celiac artery, classification, angiography, variations, computed tomography, embryology




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