The origin of the inferior phrenic artery: a study in 32 South Indian cadavers with a review of the literature

Thejodhar Pulakunta,Venkata Ramana Vollala,Muddanna S Rao,Sampath Madhyastha,Vasavi Rakesh Gorantla,Bhagath Kumar Potu

doi:10.1590/s1677-54492007000300005

Thejodhar Pulakunta, Venkata Ramana Vollala + Show 4 more

Open Access

https://doi.org/10.1590/s1677-54492007000300005

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Abstract

BACKGROUND: Considering the paucity of information presently available concerning inferior phrenic arteries, a more definitive study seemed appropriate and necessary, both for its potential clinical applications and to provide additional data to contemporary anatomical literature. OBJECTIVE: Most anatomical textbooks of gross anatomy offer very little information concerning the anatomy and distribution of the inferior phrenic artery (IPA). For that reason, the origin of the IPA has been studied and the available literature has been reviewed. METHODS: Thirty-two human adult cadavers preserved in formalin obtained from the departments of Anatomy, Kasturba Medical College, Manipal and Mangalore were dissected and the origin of the IPA was studied. RESULTS: The IPA had its usual origin from the abdominal aorta in 28 cases but in the remaining four cases, two were arising from the celiac trunk, one from the left gastric artery and one from the right renal artery. CONCLUSION: The IPA usually originates from the aorta or celiac artery, and less frequently from the renal, hepatic or left gastric arteries. The IPA is a major source of collateral or parasitized arterial supply to hepatocellular carcinoma, second only to the hepatic artery. Literature on the IPA origin and clinical implications of variation in its origin have been reviewed in this article.

Highlights

Descriptions of the right inferior phrenic artery (RIPA) and left inferior phrenic artery (LIPA) are typically very brief and lacking in detail in anatomy textbooks, they have received increased attention in recent years in the clinical literature
The IPA is a major source of collateral or parasitized arterial supply to hepatocellular carcinoma, second only to the hepatic artery
It was seen to arise directly from the celiac trunk in two cases (Figures 1 and 2) and there was one case arising from the left gastric artery (Figure 3) and another from the right renal artery (Figure 4)

Summary

Introduction

Descriptions of the right inferior phrenic artery (RIPA) and left inferior phrenic artery (LIPA) are typically very brief and lacking in detail in anatomy textbooks, they have received increased attention in recent years in the clinical literature. This stems largely from the discovery of the involvement of the right (most frequently) or left inferior phrenic arteries in the arterial supply and growth of hepatocellular carcinoma (HCC).[1,2] the great importance of such knowledge lies in the fact that an unresectable HCC can be treated by transcatheter embolization of its typical blood supply, the right or left hepatic arteries, and by embolization of a RIPA, if involved.[1,2,3,4]. Considering the paucity of information presently available concerning inferior phrenic arteries, a more definitive study seemed appropriate and necessary, both for its potential clinical applications and to provide additional data to contemporary anatomical literature

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