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BACKGROUND: Transcatheter arterial chemoembolization is a common treatment for patients with inoperable hepatocellular carcinoma. If the carcinoma is advanced or the main arterial supply, the hepatic artery, is occluded, extrahepatic collateral arteries may develop. Both, right and left inferior phrenic arteries (RIPA and LIPA) are the most frequent and important among these collaterals. However, the topographic anatomy of these arteries has not been described in detail in anatomy textbooks, atlases and most previous reports. AIMS: To investigate the anatomy and branching patterns of RIPA and LIPA on cadavers and compare our results with the literature. STUDY DESIGN: Descriptive study. METHODS: We bilaterally dissected 24 male and 2 female cadavers aged between 49 and 88 years for this study. RESULTS: The RIPA and LIPA originated as a common trunk in 5 cadavers. The RIPA originated from the abdominal aorta in 13 sides, the renal artery in 2 sides, the coeliac trunk in 1 side and the left gastric artery in 1 side. The LIPA originated from the abdominal aorta in 9 sides and the coeliac trunk in 6 sides. In 6 cadavers, the ascending and posterior branches of the LIPA had different sources of origin. CONCLUSION: As both the RIPA and LIPA represent the half of all extrahepatic arterial collaterals to hepatocellular carcinomas, their anatomy gains importance not only for anatomists but interventional radiologists as well.
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OBJECTIVE: To determine not only the vertical but also horizontal localization of the adductor hiatus (AH) and classify its shape and structure macroscopically. MATERIAL AND METHODS: Forty lower extremities were dissected to expose the AH. Its shape and structure were macroscopically noted, and the AH was classified into four types. For determining the localization, measurements were made with digital calipers. RESULTS: Twenty-four oval fibrous types, 12 oval muscular types, 2 bridging fibrous types and 2 bridging muscular types of AH were determined. For the horizontal localization of AH, the apex of the AH was determined to be located medial to the vertical line between the midpoint of the interepicondylar distance and the line which was drawn transversely from the apex of the AH, in all of the cadavers. For the vertical one, the apex of the AH was located in the middle third of the femur length in 14 thighs, and in the remaining 26 ones, the apex of the AH was located in the distal third of the femur length. CONCLUSION: Adductor hiatus was classified according to its shape and structure for the first time. Moreover, the localization of the AH was practically defined, in order not to harm the popliteal artery and vein.
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PURPOSE: The aim of this study was to assess the course of the superficial branch of the radial nerve (SBRN) at the level of the wrist and its branches in relation to wrist arthroscopy portals. METHODS: Dissections were performed on 11 hands from 6 cadavers in the section starting from the point where the SBRN begins to emerge and ending at the terminal branches of the dorsal hand. The distribution of the SBRN, the distance from the superficial branch to the dorsal portals used in wrist arthroscopy, and the distance from the superficial branch to the anatomic determinants (styloid process of the radius, Lister tubercle) were studied. RESULTS: At the level of the wrist, the nerve bifurcated into 2 branches in 8 of 11 wrists (73%) and into 3 branches in 3 of 11 wrists (27%). The mean distance from the SBRN where it was first detected proximal to the Lister tubercle was 73 mm. The mean distance between the styloids was 52 mm; the distance between the Lister tubercle and styloid process of the radius was 23 mm. At the wrist level, the distance from the branch closest to the radial side to the Lister tubercle was 28 mm (L-D1), 21 mm (L-D2/3), and 7 mm (RS-D1). The distance of the closest nerve branch to the 3-4 portal was 9 mm. The distances of the other portals were 5 mm (1-2RMC-D1), 8 mm (1-2RMC-D2/3), 8 mm (1-2P-D1), and 9 mm (1-2P-D2/3). CONCLUSIONS: The limited size of the area where portals can be positioned and the anatomic variations between individuals are major obstacles in developing a guideline for reducing the risk of SBRN injury in wrist arthroscopy. CLINICAL RELEVANCE: Great care must be taken when using the 1-2 portal. We suggest making a skin-only incision for this portal and then using blunt dissection to help prevent injury to the SBRN.