![3D Medical Animation still shot Cystic Artery](https://upload.wikimedia.org/wikipedia/commons/d/d1/3D_Medical_Animation_still_shot_Cystic_Artery.jpg)
The cystic artery (also known as bachelor artery) supplies oxygenated blood to the
gallbladder
In vertebrates, the gallbladder, also known as the cholecyst, is a small hollow organ where bile is stored and concentrated before it is released into the small intestine. In humans, the pear-shaped gallbladder lies beneath the liver, although ...
and
cystic duct
The cystic duct is the short duct that joins the gallbladder to the common hepatic duct. It usually lies next to the cystic artery. It is of variable length. It contains ' spiral valves of Heister', which do not provide much resistance to the ...
.
Most common arrangement
In the classic arrangement, occurring with a frequency of approximately 70%, a singular cystic artery originates from the geniculate flexure of the
right hepatic artery
The hepatic artery proper (also proper hepatic artery) is the artery that supplies the liver and gallbladder. It raises from the common hepatic artery, a branch of the celiac artery.
Structure
The hepatic artery proper arises from the common h ...
in the upper portion of the
hepatobiliary triangle
The cystohepatic triangle (or hepatobiliary triangle) is an anatomic space bordered by the cystic duct inferiorly, the common hepatic duct medially, and the inferior surface of the liver superiorly. The cystic artery lies within the hepatobiliary ...
.
A site of origin from a more proximal or distal portion of the right hepatic artery is also considered relatively normal.
After separating from the right hepatic artery, the cystic artery travels superiorly to the
cystic duct
The cystic duct is the short duct that joins the gallbladder to the common hepatic duct. It usually lies next to the cystic artery. It is of variable length. It contains ' spiral valves of Heister', which do not provide much resistance to the ...
and produces 2 to 4 minor branches, known as ''Calot’s arteries'', that supply part of the cystic duct and cervix of the gallbladder before dividing into the major superficial and deep branches at the superior aspect of the gallbladder neck:
* The ''superficial branch'' (or ''anterior branch'') passes subserously over the left aspect of the gallbladder.
* The ''deep branch'' (or ''posterior branch'') runs between the gallbladder and gallbladder fossa, terminating at the peritoneum attached to the liver surface.
Anatomic variation
Double cystic artery
When superficial and deep branches of the cystic artery do not share a common origin it is defined as a ''double cystic artery'' occurring with a frequency of 15%.
The deep branch consistently arises from the right hepatic artery which is generally also the source of origin of the superficial branch, however in some cases it has been found to initiate from the anterior segmental artery, middle hepatic artery, left hepatic artery,
superior mesenteric artery
In human anatomy, the superior mesenteric artery (SMA) is an artery which arises from the anterior surface of the abdominal aorta, just inferior to the origin of the celiac trunk, and supplies blood to the intestine from the lower part of the du ...
,
gastroduodenal artery
In anatomy, the gastroduodenal artery is a small blood vessel in the abdomen. It supplies blood directly to the pylorus (distal part of the stomach) and proximal part of the duodenum. It also indirectly supplies the pancreatic head (via the anterio ...
or
retroduodenal artery.
Approximately half of superficial cystic arteries have been shown to enter through the hepatobiliary triangle, while deep cystic arteries are often quite small in length and diameter. Tripling of the cystic artery is very rare, occurring in between 0-0.3% of cases.
Aberrant origin of the right hepatic artery
Unusual anatomy of the right hepatic can itself affect the path and form of the cystic artery, with the most frequent variation resulting from an ''aberrant origin of the right hepatic artery'' which is described in between 2-16% of cases.
Generally this anomalous source is the superior mesenteric artery or more rarely the abdominal aorta, producing what has been described as a "replacing right hepatic artery", passing through the hepatobiliary triangle and running posterior and parallel to the cystic duct.
Because of the close proximity to the gallbladder to the (replacing) right hepatic artery a "caterpillar" or "Moynihan's" hump may form and this artery generally produces multiple short cystic branches rather than a single cystic artery.
Left hepatic artery
The cystic artery can arise from the ''left hepatic artery'', and in such a case it usually travels through a passage of liver
parenchyma, approaching the neck of the gallbladder, before
bifurcating into ascending (or superior) and descending (or inferior) branches. This situation is found in roughly 1% of cases.
This form of the cystic artery does not pass through the hepatobiliary triangle and has been found located both anteriorly and posteriorly to the common hepatic duct.
Recurrent cystic artery
In less than 1% of patients a form known as a ''recurrent cystic artery'' is found – the cystic artery arises from the left hepatic artery and passes through either the cholecystoduodenal or cholecystocolic ligaments (connecting the gallbladder to the duodenum and transverse colon respectively), follows the right edge of the
hepatoduodenal ligament
The hepatoduodenal ligament is the portion of the lesser omentum extending between the porta hepatis of the liver and the superior part of the duodenum.
Running inside it are the following structures collectively known as the portal triad:
* hep ...
, and connects to the fundus of the gallbladder before descending to supply the body and neck.
Low-lying cystic artery
When a single cystic artery arises from gastroduodenal artery it forms a configuration is known as ''low-lying cystic artery'', as it passes inferior to the cystic duct through the cholecystoduodenal ligament, and therefore remains outside the hepatobiliary triangle.
This condition has alternatively been described as an inferior cystic artery and transposition of the cystic artery and duct with a prevalence at approximately 5%.
In 25% of these patients with this course there will be a secondary arterial supply to the gallbladder, with the low-lying artery acting as the equivalent of the posterior branch.
Enlarged cystic artery
Sometimes enlarged cystic artery can be found during cholecystectomy.
Clinical significance
It must be identified and ligated in operations that remove the gallbladder (
cholecystectomies).
References
External links
Cystic artery- thefreedictionary.com
*
*
*
* ()
*
![Figure 1-1](https://upload.wikimedia.org/wikipedia/commons/d/d3/Figure_1-1.jpg)
Enlarged cystic artery (General University Hospital of Patras, Greece)
{{Authority control
Arteries of the abdomen