Anatomical Variations of the Hepatic Artery branching Patterns: A Retro-Prospective Contrast-Enhanced Computed Tomography Study

International Journal of Anatomy and Physiology | Vol. 15, No. 8, August 2026 | pp. 036–048

DOI: 10.46882/2026/IJAP/000171

Article Type: Original Research Article

Title: Anatomical Variations of the Hepatic Artery branching Patterns: A Retro-Prospective Contrast-Enhanced Computed Tomography Study

Names of Authors: Elena R. Dimitrova¹, Ivan P. Stoyanov²

Authors’ Affiliations: ¹Department of Anatomy, Histology and Embryology, Medical University of Sofia, Sofia, Bulgaria; ²Department of Diagnostic Imaging, University Hospital St. Ivan Rilski, Sofia, Bulgaria

Abstract:
Surgical interventions in the upper abdomen, including liver transplantations, pancreatectomies, and transarterial chemoembolization, demand a precise understanding of hepatic arterial anatomy to avoid accidental ligation or ischemic complications. This study aimed to classify the anatomical variations of the hepatic artery using contrast-enhanced computed tomography (CECT) scans based on Michels' classification system. A retrospective and prospective review of 450 abdominal CECT angiograms was conducted over a five-year period. Classic normal anatomy (Type I), where the common hepatic artery originates from the celiac trunk and divides into the gastroduodenal and proper hepatic arteries, was observed in 68.2% of the cases (n = 307). Anatomical variants were identified in 31.8% of the cohort (n = 143). The most prevalent variant was Michels' Type III (a replaced right hepatic artery arising from the superior mesenteric artery), found in 11.1% of patients. Michels' Type II (a replaced left hepatic artery originating from the left gastric artery) occurred in 7.3% of the cases. Accessory right and left hepatic arteries (Types V and VI) were documented in 4.2% and 3.6% of the population, respectively. Rare configurations not matching Michels' classic descriptions, such as a celiomesenteric trunk, were observed in 1.8% of individuals. This large-scale imaging study confirms that classical hepatic arterial anatomy is absent in nearly one-third of the population, emphasizing the critical value of multi-detector CECT mapping prior to hepatobiliary surgeries.

Keywords: Hepatic Artery, Anatomical Variations, Michels' Classification, Computed Tomography, Celiac Trunk

Manuscript Timeline: Received: May 29, 2026; Revised: July 09, 2026; Accepted: July 28, 2026; Published: August 21, 2026

Citation: Dimitrova E.R., & Stoyanov I.P. (2026). Anatomical Variations of the Hepatic Artery branching Patterns: A Retro-Prospective Contrast-Enhanced Computed Tomography Study. International Journal of Anatomy and Physiology, 15(8), 036–048. DOI: 10.46882/2026/IJAP/000171

Subscribe to read the full article: https://www.internationalscholarsjournals.org/subscribe-to-read