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Authors
Imamura, Hajime https://orcid.org/0000-0002-7205-7757
Adachi, Tomohiko https://orcid.org/0000-0001-7025-6173
Hamada, Takashi https://orcid.org/0000-0002-8438-750X
Migita, Kazushige https://orcid.org/0009-0003-7971-1621
Satoh, Ayaka
Kurotaki, Kouki
Nakamura, Shun
Ogawa, Shinichiro
Askeyev, Baglan https://orcid.org/0000-0002-3695-7811
Matsushima, Hajime https://orcid.org/0000-0002-1577-6587
Kinoshita, Ayaka
Soyama, Akihiko https://orcid.org/0000-0003-2932-4300
Eguchi, Susumu https://orcid.org/0000-0002-7876-0152
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Article History
Received: 5 November 2025
Accepted: 3 January 2026
First Online: 16 January 2026
Declarations
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: This study was conducted in accordance with the Declaration of Helsinki and the Ethical Guidelines for Clinical Studies of the Ministry of Health, Labour and Welfare of Japan. The protocol was approved by the Ethics Committee of Nagasaki University Hospital (Approval No. 19102143).
: The authors declare no competing interests.
: Dr. Hajime Imamura, Dr. Tomohiko Adachi, Dr. Takashi Hamada, Dr. Kazushige Migita, Dr. Ayaka Satoh, Dr. Kouki Kurotaki, Dr. Shun Nakamura, Dr. Shinichiro Ogawa, Dr. Baglan Askeyev, Dr. Hajime Matsushima, Dr. Ayaka Kinoshita, Dr. Akihiko Soyama, and Prof. Susumu Eguchi have no conflicts of interest or financial ties to disclose,
: A video clip showing the intraoperative handling of the variant artery is included as Supplementary Video 1 (as Case 1: A typical case of r-RHA, Case 2: Rare variant case).
