Alex Fourdrain1,2, Florence De Dominicis3, Chloé Blanchard3, Jules Iquille3, Sophie Lafitte3, Pierre-Louis Beuvry3, David Michel4, Geoni Merlusca3, Eric Havet5, Pascal Berna3. 1. Thoracic Surgery Department, Amiens University Hospital, University of Picardy, 80054, Amiens cedex 01, France. fourdrain.alex@chu-amiens.fr. 2. Laboratory of Anatomy and Organogenesis, Jules Verne University of Picardy, Amiens, France. fourdrain.alex@chu-amiens.fr. 3. Thoracic Surgery Department, Amiens University Hospital, University of Picardy, 80054, Amiens cedex 01, France. 4. Diagnostic Radiology Department, Amiens University Hospital, Amiens, France. 5. Laboratory of Anatomy and Organogenesis, Jules Verne University of Picardy, Amiens, France.
Abstract
PURPOSE: Anatomic variations of the pulmonary arterial tree can cause technical difficulties during pulmonary lobectomy in general and video-assisted thoracic surgery (VATS). Using CT angiography and 3D reconstruction, we sought to identify anatomic variations of the pulmonary arterial tree and assess their respective frequencies. METHODS: We retrospectively studied 88 pulmonary arterial trees in 44 patients having undergone VATS lobectomy for lung cancer over an 18-month period in Amiens University Hospital's Department of Thoracic Surgery. Each CT angiography with 3D reconstruction of the pulmonary arterial tree was performed by two experienced operators, according to a standardized procedure. RESULTS: On the right side, the upper lobe was supplied with blood by a mediastinal artery in 100% of cases and by one or more fissural arteries in 88.6%. The middle lobe was usually supplied by two arteries (54.5%). The upper segment of the right lower lobe was usually supplied by a single artery (90.9%). We identified 11 variations in the vasculature of the basal segments. On the left side, the upper lobe was supplied by four arteries in 50% of cases, three culminal arteries (50%), and a fissural lingular artery (77.3%). The upper segment of the left lower lobe was usually supplied by a single artery (65.9%). We identified 15 anatomic variations in the vasculature of the basal segments. We observed that the origin of the apical artery of the right lower lobe was proximal to the origin of the middle lobe artery in 38.6% of cases. The origin of the apical artery of the left lower lobe artery was proximal to the origin of the lingular fissural artery in 65.9% of cases. CONCLUSION: The findings of the present CT angiography/3D reconstruction study agreed with the reference works on the anatomy of the pulmonary arterial tree and defined the frequency of anatomic variations. It is essential to assess the anatomy of the pulmonary arterial tree before VATS lobectomy.
PURPOSE: Anatomic variations of the pulmonary arterial tree can cause technical difficulties during pulmonary lobectomy in general and video-assisted thoracic surgery (VATS). Using CT angiography and 3D reconstruction, we sought to identify anatomic variations of the pulmonary arterial tree and assess their respective frequencies. METHODS: We retrospectively studied 88 pulmonary arterial trees in 44 patients having undergone VATS lobectomy for lung cancer over an 18-month period in Amiens University Hospital's Department of Thoracic Surgery. Each CT angiography with 3D reconstruction of the pulmonary arterial tree was performed by two experienced operators, according to a standardized procedure. RESULTS: On the right side, the upper lobe was supplied with blood by a mediastinal artery in 100% of cases and by one or more fissural arteries in 88.6%. The middle lobe was usually supplied by two arteries (54.5%). The upper segment of the right lower lobe was usually supplied by a single artery (90.9%). We identified 11 variations in the vasculature of the basal segments. On the left side, the upper lobe was supplied by four arteries in 50% of cases, three culminal arteries (50%), and a fissural lingular artery (77.3%). The upper segment of the left lower lobe was usually supplied by a single artery (65.9%). We identified 15 anatomic variations in the vasculature of the basal segments. We observed that the origin of the apical artery of the right lower lobe was proximal to the origin of the middle lobe artery in 38.6% of cases. The origin of the apical artery of the left lower lobe artery was proximal to the origin of the lingular fissural artery in 65.9% of cases. CONCLUSION: The findings of the present CT angiography/3D reconstruction study agreed with the reference works on the anatomy of the pulmonary arterial tree and defined the frequency of anatomic variations. It is essential to assess the anatomy of the pulmonary arterial tree before VATS lobectomy.
Entities:
Keywords:
3D reconstruction; Anatomic variation; CT angiography; Pulmonary artery; Video-assisted thoracic surgery lobectomy
Authors: A Fourdrain; F De Dominicis; M Bensussan; J Iquille; S Lafitte; D Michel; P Berna Journal: Folia Morphol (Warsz) Date: 2016-12-27 Impact factor: 1.183
Authors: Min Zhang; Ning Mao; Ke Zhang; Miao Zhang; Yun Liu; Ren-Feng Wang; Tao Xiong; Gang Huang; Jian-Fei Shen; Jun Liu; Qing-Chen Wu; Ming-Jian Ge Journal: Ann Transl Med Date: 2020-11