Anatomy of the Inferior Mesenteric Artery Evaluated Using 3-Dimensional CT Angiography

Murono, Koji; Kawai, Kazushige; Kazama, Shinsuke; Ishihara, Soichiro; Yamaguchi, Hironori; Sunami, Eiji; Kitayama, Joji; Watanabe, Toshiaki

doi:10.1097/dcr.0000000000000285

Cited by 73 publications

(77 citation statements)

References 27 publications

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“…CT angiography can aid surgeons in identifying anatomical vascular variations preoperatively (10,11). In all three cases, it was easy to obtain anatomical imaging of these collateral arteries via CT angiography.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic surgery for colorectal cancers complicated by Leriche syndrome: A report of three cases

et al. 2017

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Leriche syndrome is a disease of aortoiliac occlusion, which causes diminished femoral pulses, impotence and claudication. As blood flow to the rectum is also decreased in Leriche syndrome, reconstruction with anastomosis may be complicated by ischemia when performing rectal cancer surgery. The inferior epigastric arteries often provide collateral circulation to the lower limbs in patients with Leriche syndrome, therefore, attention should be paid not to injure them during trocar insertion when performing laparoscopic surgeries. The present study is a report on three cases of patients with colorectal cancer who were successfully treated with laparoscopic surgeries. The first case was of a 71-year-old man with rectal cancer. A preoperative computed tomography (CT) scan revealed occlusion of the aorta below the origin of the inferior mesenteric artery. The blood flow to the lower limbs was supplied through collateral arteries, including the inferior epigastric arteries and the deep circumflex iliac arteries. A laparoscopic Hartmann's operation was performed successfully following marking of the inferior epigastric arteries using ultrasonography to avoid damaging them during trocar insertion. The second case involved a 70-year-old man with three colorectal cancers of the transverse and sigmoid colon and rectum. A CT scan revealed occlusion of the aorta below the origin of the renal arteries. Laparoscopic assisted low anterior resection and left hemicolectomy with colostomy were performed. The final patient was a 61-year-old man with rectal cancer. As the right internal iliac artery was patent, the patient underwent laparoscopic assisted low anterior resection. All the patients were discharged from the hospital without complications. It is important to visualize the image the blood flow via CT angiography and to mark collateral arteries using ultrasonography preoperatively in patients with Leriche syndrome for whom laparoscopic surgery was planned for to treat colorectal cancer.

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Section: Discussionmentioning

confidence: 99%

Laparoscopic surgery for colorectal cancers complicated by Leriche syndrome: A report of three cases

et al. 2017

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“…However, problems may arise during ligation of mesenteric arteries because of the narrow field of view. MDCTA offers the possibility of safer laparoscopic colon and rectal surgery by providing preoperative information about variations in vascular anatomy and branch structures …”

Section: Discussionmentioning

confidence: 99%

Multidetector computed tomography angiography to evaluate the subscapular arterial tree

et al. 2015

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“…For the diagnosis of intestinal angina and ischemic colitis is essential for the radiologist to understand all possible variant of the IMA. The same apply for a surgeon in the case of intestinal and abdominal operations (malignancies, compressions, occlusive disease, right hemicolectomy, resection of the transverse colon, left hemicolectomy, sigmoidectomy, en bloc resection of the head of the pancreas and the superior mesenteric vessels, colonic interposition in severe oesophagus carcinomas) [19][20][21], in vascular reconstruction (anastomosing blood vessels, IMA re-implantation) [22] and in safely when performing laparoscopic surgery in the left-side colon and rectum [23]. It is essential thus, for all interventional practitioners to comprehend IMA anatomical branching pattern, as well as its variations [24].…”

Section: Discussionmentioning

confidence: 99%

“…Although IMA's branching pattern shows important variability, the variations considering its point of origin seem to be rather rare [3]. Generally, IMA is very stable, arising directly from the AA, with a widely varied length from 10.1 to 82.2 mm [4]. Savchenko and Shendrik…”

Section: Introductionmentioning

confidence: 99%

An Inferior Mesenteric Artery Arising From the Left Common Iliac Artery

Panagouli¹,

Tsoucalas²,

Fiska³

et al. 2018

IJAR

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Address for Correspondence: Gregory Tsoucalas, Ierolohiton 155, Agioi Anargyroi 38334, Volos, Greece. Cell phone 00306945298205, E-Mail: gregorytsoucalas@yahoo.gr Although anatomical variations in abdominal vascular branching are a common phenomenon, alternations in IMA are rather rare. We report a variation found during a dissection of an embalmed male cadaver of Caucasian Hellenic origin, where we observed an IMA having as a point of origin the left common iliac artery, 0.4 cm after the AA bifurcation in the level between L3 and L4 vertebra. Ignorance of this variant may cause serious implications during vascular and abdominal surgery.

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Anatomy of the Inferior Mesenteric Artery Evaluated Using 3-Dimensional CT Angiography

Abstract: Using 3-dimensional CT angiography, preoperative understanding of the anatomic vascular variations can be easily obtained, which would help surgeons to safely perform laparoscopic surgery in the left-side colon and rectum.

Cited by 73 publications

References 27 publications

Laparoscopic surgery for colorectal cancers complicated by Leriche syndrome: A report of three cases

Laparoscopic surgery for colorectal cancers complicated by Leriche syndrome: A report of three cases

Multidetector computed tomography angiography to evaluate the subscapular arterial tree

An Inferior Mesenteric Artery Arising From the Left Common Iliac Artery

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