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Ahead of Print
ORIGINAL ARTICLES
Published online: 2020-09-15
Submitted: 2020-06-23
Accepted: 2020-08-26
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Types of inferior mesenteric artery: a proposal for a new classification

A. Balcerzak, O. Kwaśniewska, M. Podgórski, Ł. Olewnik, M. Polguj
DOI: 10.5603/FM.a2020.0115
·
Pubmed: 32964409

open access

Ahead of Print
ORIGINAL ARTICLES
Published online: 2020-09-15
Submitted: 2020-06-23
Accepted: 2020-08-26

Abstract

Background: The inferior mesenteric artery (IMA) is the third main branch of the abdominal aorta and arises at the level of L3, supplying the large intestine from the distal transverse colon to the upper part of the anal canal. The aim of this study was to characterize the course and morphology of the terminal branches of the IMA, and also creating a new IMA classification, which seems to be necessary for clinicians performing surgery in this area.

Materials and methods: The anatomical variations in the branching patterns of the inferior mesenteric artery were examined in 40 cadavers fixed in a 10% formalin solution. Morphometric measurements were then obtained twice by two researchers.

Results: Due to the proposed classification system, Type I characterized by a common trunk preceding bifurcation into sigmoidal branches and the superior rectal artery after giving LCA - Left Colic Artery occurred in 57.5% of cases, Type II, Trifurcation Type, in 25%, Type III with the superior rectal arteries originating firstly from the IMA in 5%, Type IV with the ascending lumbar artery in 10% of cases and Type V, a novelty, in 2.5%. The origin of IMA was observed at the level of L2/L3 in 22.5% of cases, at L3 in 25% of cases, at L3/L4 in 15% of cases, at L4 in 35% of cases and at the level of L5 in 2.5% of cases. More than one third (38.1%) of total cases with additional arteries and rapidly bifurcating branches occurred in Type III, IV, and V. In women only, the IMA and LCA were significantly narrower than in men. Only the diameter of the IMA correlated with the diameter of the superior rectal artery.

Conclusions: The IMA is characterized by high morphological variability. The introduction of a new, structured, anatomical classification seems necessary for all clinicians.

Abstract

Background: The inferior mesenteric artery (IMA) is the third main branch of the abdominal aorta and arises at the level of L3, supplying the large intestine from the distal transverse colon to the upper part of the anal canal. The aim of this study was to characterize the course and morphology of the terminal branches of the IMA, and also creating a new IMA classification, which seems to be necessary for clinicians performing surgery in this area.

Materials and methods: The anatomical variations in the branching patterns of the inferior mesenteric artery were examined in 40 cadavers fixed in a 10% formalin solution. Morphometric measurements were then obtained twice by two researchers.

Results: Due to the proposed classification system, Type I characterized by a common trunk preceding bifurcation into sigmoidal branches and the superior rectal artery after giving LCA - Left Colic Artery occurred in 57.5% of cases, Type II, Trifurcation Type, in 25%, Type III with the superior rectal arteries originating firstly from the IMA in 5%, Type IV with the ascending lumbar artery in 10% of cases and Type V, a novelty, in 2.5%. The origin of IMA was observed at the level of L2/L3 in 22.5% of cases, at L3 in 25% of cases, at L3/L4 in 15% of cases, at L4 in 35% of cases and at the level of L5 in 2.5% of cases. More than one third (38.1%) of total cases with additional arteries and rapidly bifurcating branches occurred in Type III, IV, and V. In women only, the IMA and LCA were significantly narrower than in men. Only the diameter of the IMA correlated with the diameter of the superior rectal artery.

Conclusions: The IMA is characterized by high morphological variability. The introduction of a new, structured, anatomical classification seems necessary for all clinicians.

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Keywords

anatomical variations, inferior mesenteric artery, left colic artery, superior rectal artery, sigmoid branches, new classification, cadavers

About this article
Title

Types of inferior mesenteric artery: a proposal for a new classification

Journal

Folia Morphologica

Issue

Ahead of Print

Published online

2020-09-15

DOI

10.5603/FM.a2020.0115

Pubmed

32964409

Keywords

anatomical variations
inferior mesenteric artery
left colic artery
superior rectal artery
sigmoid branches
new classification
cadavers

Authors

A. Balcerzak
O. Kwaśniewska
M. Podgórski
Ł. Olewnik
M. Polguj

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