%0 Journal Article
%T The decreasing prevalence of the thyroid ima artery: A systematic review and machine learning assisted meta-analysis.
%A Yurasakpong L
%A Nantasenamat C
%A Janta S
%A Eiamratchanee P
%A Coey J
%A Chaiyamoon A
%A Kruepunga N
%A Senarai T
%A Langer MF
%A Meemon K
%A Suwannakhan A
%J Ann Anat
%V 239
%N 0
%D Jan 2022
%M 34265384
%F 2.976
%R 10.1016/j.aanat.2021.151803
%X <B>BACKGROUND: </B>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.<BR><B>METHODS: </B>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).<BR><B>RESULTS: </B>Thirty-six studies with a total of 4335 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 4.5 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%).<BR><B>CONCLUSIONS: </B>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.