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In Annals of anatomy = Anatomischer Anzeiger : official organ of the Anatomische Gesellschaft

INTRODUCTION : Thyroid ima artery is a variant artery found on the anterior surface of the trachea. The aim of this meta-analysis was to obtain pooled prevalence data of the thyroid ima artery and discuss its clinical importance especially for tracheostomy.

METHODS : A systematic literature search was performed through five electronic databases until May 2021. A set of inclusion and exclusion criteria based on AQUA guidelines were used to select relevant studies. Meta-analysis, subgroup analyses, meta-regression, and tests for publication bias were performed. Factors that influence the prevalence of the thyroid ima artery were detected using simple and interpretable machine learning (linear regression and K means).

RESULTS : Thirty-six studies with a total of 4,335 subjects met the inclusion criteria. The prevalence of the thyroid ima artery was 3.8% (95% CI: 0.027-0.049,I2 = 56.2%). Machine learning identified age, region and year of publication as potential covariates. Subgroup analysis showed that the prevalence of the thyroid ima artery was almost five times higher in fetuses (14.8%) than adults (3.3%) (z=-6.76, p < 0.01). There was a significant negative correlation between the adult prevalence of the thyroid ima artery and the year of publication (Pearson's r = -0.354, p = 0.040) thereby suggesting a decline in thyroid ima artery prevalence over time. This artery, if present, may originate from the brachiocephalic trunk (74%), right common carotid artery (9.6%), arch of aorta (7.7%), right internal thoracic artery (4.8%), left common carotid artery (1.9%) and left internal thoracic artery (1.9%).

CONCLUSION : In addition to evidence-based synthesis of the thyroid ima artery, this study is the first ever study to report the decreasing prevalence over time of a human body structure in the postnatal life. Knowledge of the thyroid ima artery is of vital importance for surgeons to avoid accidental hemorrhage during tracheostomy.

Yurasakpong Laphatrada, Nantasenamat Chanin, Janta Sirorat, Eiamratchanee Pinthusorn, Coey James, Chaiyamoon Arada, Kruepunga Nutmethee, Senarai Thanyaporn, Langer Martin Franz, Meemon Krai, Suwannakhan Athikhun


machine learning, meta-analysis, systematic review, thyroid ima artery, tracheostomy