New Classification of Inferior Phrenic Artery Variations Correlated with Computed Tomography Angiography: Clinical Significance

Abstract

Background and Aim: A comprehensive understanding of the variations in the inferior phrenic artery (IPA) origin is essential for various interventional and surgical procedures utilized in treating conditions such as hepatocellular carcinoma, hemoptysis, trauma, iatrogenic injuries, and organ transplantations. In this study, we analyzed 1008 computed tomography angiography (CTA) cases and correlated the findings with the newly proposed classification of IPA variations of our study. Materials and Methods: Retrospectively evaluating IPA variations in 1040 cases, excluding 32 subjects, this study collected patient data from the hospital’s picture archiving and communication system. The analysis focused on IPA origins, including connections to the celiac artery, left gastric artery, and renal arteries. The inclusion criteria comprised routine CTA of the upper abdomen, with exclusion criteria excluding major vascular pathologies, upper abdominal surgeries, and motion artifacts. Results: An evaluation of 1008 CTA studies revealed the prevalence of IPA variations, leading to a new classification system grounded in embryology. IPA was categorized into four main types and respective subtypes: Type I (41.8%), Type II (41.4%), Type III (3.3%), and Type IV (7.2%), with detailed breakdowns of subtypes within each category. Conclusion: While recognizing the significant clinical importance of IPA variations, this study addresses the scarcity of comprehensive research on the topic. By presenting a various IPA variations, this research aims to simplify the identification and reporting of these variations for improved clinical practice.