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Original article
Submitted: 2023-11-08
Accepted: 2023-11-27
Published online: 2023-12-19
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Superior mesenteric artery clinical classification and morphometrical analysis

Radosław Chmiel1, Jakub Batko1, Aleksiej Juszczak1, Jerzy A. Walocha1, Artur Moskała2, Andrzej Dubrowski1, Krzysztof Woźniak2, Artur Pasternak1
·
Pubmed: 38152922
Affiliations
  1. Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland
  2. Department of Forensic Medicine, Jagiellonian University Medical College, Krakow, Poland

open access

Ahead of Print
ORIGINAL ARTICLES
Submitted: 2023-11-08
Accepted: 2023-11-27
Published online: 2023-12-19

Abstract

Background: The superior mesenteric artery is one of the most important arteries in the abdominal cavity, which is of great clinical importance, especially in surgical procedures and fatal ischemic complications. The aim of this study was to develop a clinical classification of the superior mesenteric artery. Materials and methods: Postmortem contrast-enhanced computed tomography of 104 (29.8% female, age 50.7±18.7) human bodies were analyzed. Based on anatomic predisposition to ischemic and iatrogenic complications, a three-tiered clinical classification of the superior mesenteric artery was developed. Type 0 was defined as standard risk for ischemic and iatrogenic complications. Type 1 was defined as increased thromboembolic risk with decreased risk of iatrogenic bleeding, and type 2 was defined as decreased ischemic risk with increased risk of iatrogenic bleeding. The supply area of the superior mesenteric artery was divided into 4 regions: pancreas, caecum, ascending colon, and transverse colon. Results: Type 0 (standard risk) was found in 62.5% of cases. Type 1 was most frequently observed in the ascending colon region (15.4%). Type 2 was most frequently observed in the pancreatic region (17.3%). Regarding type, most abnormalities were found in the region of the ascending colon (18.3%), pancreas region (17.3%), and transverse colon (16.3%). Conclusions: The proposed clinical classification of SMA links anatomic variations in morphology with their clinical significance. A simple, three-level classification can be easily applied in daily practice and serve as a great support for preoperative evaluation and recognition of patients at risk of iatrogenic or thromboembolic complications.

Abstract

Background: The superior mesenteric artery is one of the most important arteries in the abdominal cavity, which is of great clinical importance, especially in surgical procedures and fatal ischemic complications. The aim of this study was to develop a clinical classification of the superior mesenteric artery. Materials and methods: Postmortem contrast-enhanced computed tomography of 104 (29.8% female, age 50.7±18.7) human bodies were analyzed. Based on anatomic predisposition to ischemic and iatrogenic complications, a three-tiered clinical classification of the superior mesenteric artery was developed. Type 0 was defined as standard risk for ischemic and iatrogenic complications. Type 1 was defined as increased thromboembolic risk with decreased risk of iatrogenic bleeding, and type 2 was defined as decreased ischemic risk with increased risk of iatrogenic bleeding. The supply area of the superior mesenteric artery was divided into 4 regions: pancreas, caecum, ascending colon, and transverse colon. Results: Type 0 (standard risk) was found in 62.5% of cases. Type 1 was most frequently observed in the ascending colon region (15.4%). Type 2 was most frequently observed in the pancreatic region (17.3%). Regarding type, most abnormalities were found in the region of the ascending colon (18.3%), pancreas region (17.3%), and transverse colon (16.3%). Conclusions: The proposed clinical classification of SMA links anatomic variations in morphology with their clinical significance. A simple, three-level classification can be easily applied in daily practice and serve as a great support for preoperative evaluation and recognition of patients at risk of iatrogenic or thromboembolic complications.

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Keywords

superior mesenteric artery, intestinal vasculature, mesenteric ischemia, iatrogenic abdominal bleeding, classification

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About this article
Title

Superior mesenteric artery clinical classification and morphometrical analysis

Journal

Folia Morphologica

Issue

Ahead of Print

Article type

Original article

Published online

2023-12-19

Page views

171

Article views/downloads

171

DOI

10.5603/fm.98167

Pubmed

38152922

Keywords

superior mesenteric artery
intestinal vasculature
mesenteric ischemia
iatrogenic abdominal bleeding
classification

Authors

Radosław Chmiel
Jakub Batko
Aleksiej Juszczak
Jerzy A. Walocha
Artur Moskała
Andrzej Dubrowski
Krzysztof Woźniak
Artur Pasternak

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