Comparative Study of Arteriosclerosis in the Inferior and Superior Mesenteric Arteries

Demos, Nicholas J.; Bahuth, Joseph J.; Urnes, Paul D.

doi:10.1097/00000658-196204000-00018

Cited by 35 publications

(10 citation statements)

References 8 publications

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“…T h e continuity of the marginal artery enters into every colon resection where a major colic artery is ligated or there is preexisting obstruction (Demos et al, 1962) at or near its origin. This is especially important where the major colic arteries bifurcate and do not form an arcade between the branches of the bifurcation.…”

Section: Clinical Relevancementioning

confidence: 99%

Anatomic variants of the celiac, superior mesenteric, and inferior mesenteric arteries and their clinical relevance

et al. 1988

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A thorough knowledge of the anatomy of the celiac, superior mesenteric, and inferior mesenteric arteries and their variants is necessary to accomplish a successful, uncomplicated abdominal operation. We examined the anatomy of these arteries in situ in 50 adult cadavers. The classic anatomic description of the celiac, superior mesenteric, and inferior mesenteric arteries was each confirmed in only 24%, 22%, and 16% of the cadavers, respectively. This infrequent occurrence of the textbook picture was due to the presence of one or more variants in 94% resulting from differences in arterial origin and spatial relationship. A left hepatic artery of left gastric artery origin was found in 20%. A right or common hepatic artery of superior mesenteric artery origin was-observed in 14% and 6%, respectively. Of equal frequency to the classic pattern of the superior mesenteric artery was that in which the ileocolic artery arose separately and the right and middle colic arteries arose via a common trunk. The most common pattern of the inferior mesenteric artery was a left colic and a sigmoid artery arising from a common trunk with a second sigmoid artery from the inferior mesenteric artery in 28%. The embryologic basis, frequency in the literature, and clinical relevance of these variants are discussed.

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Section: Clinical Relevancementioning

confidence: 99%

Anatomic variants of the celiac, superior mesenteric, and inferior mesenteric arteries and their clinical relevance

et al. 1988

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“…It is usually thought that two or more mesenteric arteries need to be involved for symptoms of CMI to be present. Symptomatic CMI resulting from large intestinal ischemia predominantly from significant IMA stenosis has not been well characterized despite the facts that IMA involvement has been shown to be as high as 70% in patients with mesenteric artery occlusion, and that the IMA has been shown to have atherosclerotic changes more frequently and with greater severity than the other mesenteric arteries [3, 4]. We present four cases of symptomatic CMI resulting from AMAS primarily affecting the IMA focusing on their unique symptomatology and highlighting their management with percutaneous transluminal mesenteric artery stenting (PTMAS).…”

Section: Introductionmentioning

confidence: 99%

Atherosclerotic inferior mesenteric artery stenosis resulting in large intestinal hypoperfusion: A paradigm shift in the diagnosis and management of symptomatic chronic mesenteric ischemia

Lotun

Shetty

Topaz

2012

Cathet Cardio Intervent

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Symptomatic chronic mesenteric ischemia results from intestinal hypoperfusion and is classically thought to result from involvement of two or more mesenteric arteries. The celiac artery and superior mesenteric artery are most frequently implicated in this disease process, and their involvement usually results in symptoms of small intestinal ischemia. Symptomatic chronic mesenteric ischemia resulting predominantly from inferior mesenteric artery involvement has largely been overlooked but does gives rise to its own, unique clinical presentation with symptoms resulting from large intestinal ischemia. We present four patients with atherosclerotic inferior mesenteric artery stenosis with symptomatic chronic mesenteric ischemia that have unique clinical presentations consistent with large intestinal ischemia that resolved following percutaneous endovascular treatment of the inferior mesenteric artery stenosis. These cases represent a novel approach to the diagnosis and management of this disease process and may warrant a further subclassification of chronic mesenteric ischemia into chronic small intestinal ischemia and chronic large intestinal ischemia.

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“…Atheromatous change has been shown to occur more frequently and with greater severity in the IMA than in the superior mesenteric artery (Demos et al, 1962).…”

Section: Resultsmentioning

confidence: 99%

Anatomical considerations on Sudeck's critical point and its relevance to colorectal surgery

et al. 2006

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Sudeck's critical point at the rectosigmoid junction is described as the point of origin of the last sigmoid arterial branch, originating from the inferior mesenteric artery (IMA). There is controversy on the importance of Sudeck's point, and the frequency in which the anastomosis is found. Furthermore, the diameter of the anastomosis, if present, may also impact on the viability of the caudal stump. This study aimed to determine the frequency in which a macroscopic anastomosis occurs, between the superior rectal artery and the last sigmoidal branch, in a cadaver population; the diameter of this anastomosis and the distance from the origin of the IMA to Sudeck's point. Sixty‐four cadavers were included in the study, excluding those with previous surgery to the rectosigmoid junction. Sudeck's point was carefully identified and dissected to establish the presence of an anastomosis. Subsequent measurements were performed using a digital caliper (accuracy = 0.01 mm). A macroscopic anatomosis was absent in three cases (4.7%). The mean diameter of the anastomosis when present was 1.9 mm (SD: 0.5 mm), and the distance from the origin of the IMA to Sudeck's point was 55.5 mm (SD: 14.6 mm). Although an anastomosis is present in the majority of cases, the vessel is very small in diameter, and may not be sufficient to meet the demands of the caudal stump. The distance from the origin of the IMA to Sudeck's point is sufficient enough to allow for ligation of the IMA proximal to Sudeck's point. Clin. Anat. 20:424–427, 2007. © 2006 Wiley‐Liss, Inc.

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Comparative Study of Arteriosclerosis in the Inferior and Superior Mesenteric Arteries

Cited by 35 publications

References 8 publications

Anatomic variants of the celiac, superior mesenteric, and inferior mesenteric arteries and their clinical relevance

Anatomic variants of the celiac, superior mesenteric, and inferior mesenteric arteries and their clinical relevance

Atherosclerotic inferior mesenteric artery stenosis resulting in large intestinal hypoperfusion: A paradigm shift in the diagnosis and management of symptomatic chronic mesenteric ischemia

Anatomical considerations on Sudeck's critical point and its relevance to colorectal surgery

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