Anatomical variations and morphometric characteristics of the common hepatic artery: a computed tomography angiography study in 1347 patients.

PURPOSE: The common hepatic artery (CHA) demonstrates considerable anatomical variability with important implications for hepatobiliary, pancreatic, transplant, and endovascular procedures. This study aimed to evaluate the prevalence, morphometric characteristics, and three-dimensional topographic relationships of CHA variations using computed tomography angiography (CTA) in a large cohort. METHODS: This retrospective study included 1347 consecutive patients (604 women, 743 men; mean age 55.1 ± 14.4 years) who underwent abdominal CTA. Hepatic arterial anatomy was classified according to the Hiatt and Song classifications. Morphometric parameters of the celiac trunk, CHA, gastroduodenal artery, and proper hepatic artery, and the three-dimensional relationships of the CHA to adjacent structures, were evaluated using multiplanar reformation, maximum-intensity projection, and volume-rendering techniques. Comparisons were performed according to sex, age group, and variation status. RESULTS: Conventional hepatic arterial anatomy (Hiatt type I) was identified in 64.7% of patients, whereas 35.3% had variant anatomy, most commonly an isolated left hepatic artery variation (13.4%). The CHA originated predominantly from the celiac trunk (97.0%), with hepatomesenteric (2.3%) and direct aortic (0.7%) origins being uncommon. Male patients had significantly larger arterial calibres, and most morphometric parameters increased with age. Variant anatomy was associated with longer CHA, greater celiac trunk-to-CHA distance, wider departure angle, and more frequent retropancreatic, intrapancreatic, and portal/superior mesenteric venous confluence-related courses (all p < 0.001). CONCLUSION: Hepatic arterial variation is associated with distinct morphometric and topographic characteristics. These population-specific reference data may improve preoperative assessment and support safer hepatobiliary, pancreatic, transplant, and endovascular interventions by improving procedural planning and reducing vascular injury.