Pancreaticoduodenal arterial arcades: Their dominance and variations - their potential clinical relevance

Abstract

Introduction: The complex arterial system makes pancreatic interventions technically challenging for surgeons, and interventional radiologists. The arterial variants may alter tumor resecability, and cause complications in arterial embolization. International data on pancreatic blood supply are variable; therefore, we aimed to determine the frequency of variants of pancreaticoduodenal arterial arcades.

Materials and Methods: Arteries of human abdominal organ complexes (50) were injected with resin mixture, and then corroded. CT scans and 3D reconstructions were made; diameters of arcades were measured.

Results: Two pancreaticoduodenal arcades were found in 58%, three arcades in 30%, one arcade in three cases, four arcade in one specimen and five arcades in two cases. In the casts with two arches the average diameter was 1.472 ± 0.432 mm on the anterior and 1.383 ± 0.343 mm on the posterior arch. Assessing the dominance of the pancreaticoduodenal arcades, the anterior arch proved to be dominant in 52% of the cases, and in 35% the posterior one by the criterion of 25% cross-section difference.

Conclusions: It is advised to analyze the variations and dominance on a CT/MR-angiography before local chemotherapy. Furthermore, to reveal the arterial variations, a preoperative CT/MR-angiography would provide faster recuperation and better postoperative life quality. This article is protected by copyright. All rights reserved.

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