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Comprehensive analysis of splenic artery variations using computed tomography angiography: development of the IPALGEA classification system

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Abstract

Background

The splenic artery, an essential component of abdominal vascular anatomy, exhibits significant variations with clinical implications in surgical and radiological procedures. The lack of a standardized classification system for these variations hinders comparative studies and surgical planning. This study introduces the IPALGEA classification system, based on computed tomography angiography (CTA) findings, to address this gap.

Methods

A retrospective analysis was conducted on 302 patients who underwent CTA at a tertiary university hospital between August 2021 and January 2022. The study focused on the evaluation of splenic artery variations, including the origin, course, terminal branching patterns, and the relationship between the inferior polar artery and the left gastroepiploic artery. The IPALGEA classification was developed to standardize the reporting of these variations.

Results

The study highlighted a significant prevalence of splenic artery variations, with the most common pattern being a superior course relative to the pancreas. The IPALGEA classification effectively categorized these variations, emphasizing the relationship between the inferior polar artery and the left gastroepiploic artery. The findings revealed that the bifurcation distance of the celiac trunk varied significantly between genders and that the presence of an inferior polar artery correlated with a shorter hilus distance.

Conclusion

The IPALGEA classification offers a comprehensive and standardized approach to categorize splenic artery variations. This system enhances our understanding of abdominal vascular anatomy and has significant implications for surgical and radiological procedures, potentially reducing surgical complications and improving patient outcomes.

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Authors and Affiliations

  1. Department of Radiology, Akdeniz University School of Medicine, Antalya, Turkey

    Enis Bilek, Ayşe Keven & Ahmet Gökhan Arslan

Authors
  1. Enis Bilek
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  2. Ayşe Keven
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  3. Ahmet Gökhan Arslan
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Contributions

EB: conceptualization, data collection, manuscript draft-writing. AK: conceptualization, data analysis, methodology, manuscript draft-writing. AGA: supervision, manuscript reviewing-editing.

Corresponding author

Correspondence to Ayşe Keven.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. The study protocol was approved by the university’s ethics committee (Approval Date: 16.03.2022, Approval No.146).

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Bilek, E., Keven, A. & Arslan, A.G. Comprehensive analysis of splenic artery variations using computed tomography angiography: development of the IPALGEA classification system. Surg Radiol Anat 46, 363–376 (2024). https://doi.org/10.1007/s00276-024-03301-4

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