Inferior Phrenic Artery: Anatomy, Variations, Pathologic Conditions, and Interventional Management

Dong II Gwon, MD , Gi-Young Ko, MD , Hyun-Ki Yoon, MD ,o Kyu-Bo Sung, MD , Jae Moung Lee, MD , Seok Jong Ryu, MD , Myong Hee Seo, MD Jae-Chan Shim, MD , Ghi Jai Lee, MD , Ho Kyun Kim, MD.

The inferior phrenic artery (IPA) is the most common source of extra-hepatic collateral blood supply for hepatocellular carcinoma (HCC) and frequently supplies HCCs located in the bare area of the liver. Other pathologic conditions including hemoptysis, diaphragmatic or hepatic bleeding due to trauma or surgery, and bleeding caused by gas-troesophageal problems (eg, Mallory-Weiss tear or gastroesophageal cancer) may be related to the IPA. Over a 4-year period, the authors performed 383 interventional procedures related to the IPA. The right and left IPAs originate with almost equal frequency from the aorta and celiac axis and with lesser frequency from the renal arteries. Various other sites of origin such as the left gastric, hepatic, superior mesen-teric, spermatic, and adrenal arteries are also seen. Radiologists must be familiar with the normal spectrum of IPA anatomy so that detection and adequate interventional management can be achieved when patho-logic conditions related to the IPA are present.