Dimitrios K Manatakis1, Maria Piagkou2, Marios Loukas3, John Tsiaoussis4, Spiridon G Delis5, Ioannis Antonopoulos2, Dimitrios Chytas6, Konstantinos Natsis7. 1. Department of Surgery, Athens Naval and Veterans Hospital, 70 Deinokratous Str., 11521, Athens, Greece. dmanatak@yahoo.gr. 2. Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, Athens, Greece. 3. Department of Anatomical Sciences, St. George's University, St. George's, Grenada. 4. Laboratory of Anatomy, School of Medicine, University of Crete, Heraklion, Greece. 5. Department of Surgery, Konstantopouleio General Hospital, Nea Ionia, Athens, Greece. 6. European University of Cyprus, Nicosia, Cyprus. 7. Department of Anatomy and Surgical Anatomy, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloníki, Greece.
Abstract
PURPOSE: The splenic artery (SA) is the largest and most tortuous branch of the celiac trunk with a wide spectrum of variants, particularly in its terminal branches. METHODS: The current study presents a systematic review of the English literature on the SA variations, with emphasis on its terminal branching patterns. RESULTS: Thirty cadaveric studies (3132 specimens) were included in the analysis. The SA originated from the celiac trunk in 97.2%, from the abdominal aorta in 2.1% and from the superior mesenteric or the common hepatic artery in 0.7% of cases. A suprapancreatic course was observed in 77.4%, retropancreatic course in 17.8%, anteropancreatic course in 3.4% and intrapancreatic course in 1.3%. In the majority of cases, the SA bifurcated into superior and inferior lobar arteries (83.4%), with trifurcation and quadrifurcation in 11.3% and 2.7%, respectively. Five or more lobar branches (1.4%) and a single lobar artery (1.2%) were rarely identified. The distributed branching pattern was found in 72.7%, whereas the magistral pattern in 26.9%. The inferior and superior polar arteries (IPA and SPA) were found in 47.7% and 41.7% of cases, respectively, while polar artery agenesis was recorded in 28.2%. The SPA usually originated from the SA main trunk (53.6%) or from the superior lobar artery (33.1%). The IPA emanated mainly from the left gastroepiploic artery (53%), from the SA (23.5%) or the inferior lobar artery (21.9%). Intersegmental anastomoses between adjacent arterial segments were identified in 14.2%. CONCLUSION: Knowledge of the SA aberrations is important for surgeons and radiologists involved in angiographic interventions.
PURPOSE: The splenic artery (SA) is the largest and most tortuous branch of the celiac trunk with a wide spectrum of variants, particularly in its terminal branches. METHODS: The current study presents a systematic review of the English literature on the SA variations, with emphasis on its terminal branching patterns. RESULTS: Thirty cadaveric studies (3132 specimens) were included in the analysis. The SA originated from the celiac trunk in 97.2%, from the abdominal aorta in 2.1% and from the superior mesenteric or the common hepatic artery in 0.7% of cases. A suprapancreatic course was observed in 77.4%, retropancreatic course in 17.8%, anteropancreatic course in 3.4% and intrapancreatic course in 1.3%. In the majority of cases, the SA bifurcated into superior and inferior lobar arteries (83.4%), with trifurcation and quadrifurcation in 11.3% and 2.7%, respectively. Five or more lobar branches (1.4%) and a single lobar artery (1.2%) were rarely identified. The distributed branching pattern was found in 72.7%, whereas the magistral pattern in 26.9%. The inferior and superior polar arteries (IPA and SPA) were found in 47.7% and 41.7% of cases, respectively, while polar artery agenesis was recorded in 28.2%. The SPA usually originated from the SA main trunk (53.6%) or from the superior lobar artery (33.1%). The IPA emanated mainly from the left gastroepiploic artery (53%), from the SA (23.5%) or the inferior lobar artery (21.9%). Intersegmental anastomoses between adjacent arterial segments were identified in 14.2%. CONCLUSION: Knowledge of the SA aberrations is important for surgeons and radiologists involved in angiographic interventions.
Authors: Brandon Michael Henry; Krzysztof A Tomaszewski; Piravin Kumar Ramakrishnan; Joyeeta Roy; Jens Vikse; Marios Loukas; R Shane Tubbs; Jerzy A Walocha Journal: Clin Anat Date: 2016-11-18 Impact factor: 2.414