BACKGROUND: Vascular variations regarding the branching pattern of the aorta are important in different laparoscopic surgeries, liver and kidney transplantation, oncologic resections, and various interventional radiological procedures in the abdominal region. The present work was undertaken on cadavers to examine the prevalence of vascular patterns of the important branches of the abdominal aorta. MATERIAL AND METHODS: A total of 50 properly embalmed and formalin fixed cadavers were dissected in the abdominal region, and viscera were mobilised to expose the origin of important branches of the abdominal aorta. Celiac trunk, superior mesenteric, inferior mesenteric, right and left renal, left and right gonadal arteries, and the division of the abdominal aorta into right and left common iliac arteries were observed regarding their level of origin and for presence of any anatomical variations. RESULTS: The celiac trunk origin was located at the level of the T12 vertebra in 64% of cadavers, superior mesenteric at L1 in 76%, inferior mesenteric at L3 in 68%, left and right renal at L1 in 82% and 80%, respectively, and left and right gonadal at L2 in 84% and 86%, respectively; whereas the aortic bifurcation was most common at the level of the L4 vertebra in 54% of cadavers. Important anatomical variations were photographed. CONCLUSIONS: Defective fusion of the vitelline arteries during the embryonic stage resulted in the aforementioned anatomical variations. Knowledge of aortic variations is useful for appropriate radio diagnostic interventions and is helpful to decrease complications like vascular bleeding while ligating and anastomosing blood vessels, which is an integral part of many abdominal surgeries.
BACKGROUND: Vascular variations regarding the branching pattern of the aorta are important in different laparoscopic surgeries, liver and kidney transplantation, oncologic resections, and various interventional radiological procedures in the abdominal region. The present work was undertaken on cadavers to examine the prevalence of vascular patterns of the important branches of the abdominal aorta. MATERIAL AND METHODS: A total of 50 properly embalmed and formalin fixed cadavers were dissected in the abdominal region, and viscera were mobilised to expose the origin of important branches of the abdominal aorta. Celiac trunk, superior mesenteric, inferior mesenteric, right and left renal, left and right gonadal arteries, and the division of the abdominal aorta into right and left common iliac arteries were observed regarding their level of origin and for presence of any anatomical variations. RESULTS: The celiac trunk origin was located at the level of the T12 vertebra in 64% of cadavers, superior mesenteric at L1 in 76%, inferior mesenteric at L3 in 68%, left and right renal at L1 in 82% and 80%, respectively, and left and right gonadal at L2 in 84% and 86%, respectively; whereas the aortic bifurcation was most common at the level of the L4 vertebra in 54% of cadavers. Important anatomical variations were photographed. CONCLUSIONS: Defective fusion of the vitelline arteries during the embryonic stage resulted in the aforementioned anatomical variations. Knowledge of aortic variations is useful for appropriate radio diagnostic interventions and is helpful to decrease complications like vascular bleeding while ligating and anastomosing blood vessels, which is an integral part of many abdominal surgeries.
Authors: Bryan W Tillman; Youngjae Chun; Sung Kwon Cho; Yanfei Chen; Nathan Liang; Timothy Maul; Anthony Demetris; Xinzhu Gu; William R Wagner; Amit D Tevar Journal: Surgery Date: 2016-08-11 Impact factor: 3.982