Morphometric analysis of the splenic artery using contrast-enhanced computed tomography (CT)
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ORIGINAL ARTICLE
Morphometric analysis of the splenic artery using contrast‑enhanced computed tomography (CT) David J. Brinkman1,2 · Stephanie Troquay3 · Wouter J. de Jonge2 · Eric D. Irwin4,5 · Margriet J. Vervoordeldonk4 · Misha D. P. Luyer1 · Joost Nederend3 Received: 13 August 2020 / Accepted: 10 October 2020 © The Author(s) 2020
Abstract Purpose To evaluate the morphology and course of the splenic artery, which might impact the surgical implantation of systems that stimulate the nerves surrounding the splenic artery. Experimental studies indicate that these nerves play an important part in immune modulation, and might be a potential target in the treatment of autoimmune diseases. Methods This retrospective cohort study made use of contrast-enhanced CT images from 40 male and 40 female patients (age 30–69) that underwent a CT examination of the aorta, kidneys or pancreas. Anatomic features were described including total splenic artery length, calibers, tortuosity, the presence of arterial loops and the branching pattern of the splenic artery. Results No age-gender-related differences could be found related to tortuosity or branching pattern. The length of splenic artery in contact with pancreatic tissue decreased with increasing age, but was not different between genders. Artery diameters were wider in male compared to female subjects. Loops of variable directions, that represent a part of the artery that curls out of the pancreatic tissue, were identified in each age-gender category and were present in nearly all subjects (86%). Conclusion This study suggests that although some anatomic features of the splenic artery are subject to factors as age and gender, the tortuosity of the splenic artery is not age dependent. Most subjects had one or multiple loops, which can serve as a target for neuromodulatory devices. Future studies should investigate whether splenic nerve stimulation is safe and feasible. Keywords Splenic artery · Tortuosity · Computed tomography · Neuromodulation
Introduction There is a growing body of experimental data to support the hypothesis that electrical stimulation of the nerves that project to the spleen can modulate immune responses, making it a potential target for neuromodulation in the treatment of chronic inflammatory conditions [5, 14, 17]. These nerves
* David J. Brinkman [email protected] 1
Department of Surgery, Catharina Hospital, Postbus 1350, 5602 ZA Eindhoven, The Netherlands
2
Tytgat Institute for Liver and Intestinal Research, Amsterdam UMCUniversity of Amsterdam, Amsterdam, The Netherlands
3
Department of Radiology, Catharina Hospital, Eindhoven, The Netherlands
4
Galvani Bioelectronics, Stevenage, UK
5
Department of Surgery, University of Minnesota Medical School, Minneapolis, USA
form a plexus around the splenic artery before innervating the spleen [3, 6]. Therefore, the course of the splenic artery can impact the therapeutic potential of splenic nerve stimulation in humans. The study of splenic artery anatomy has been com
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