Contemporary Perspectives on the Variant Anatomy of the Superior Mesenteric Artery and Its Branches

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Abstract

This article systematizes data on the topography, origin levels, branching types, length, diameter, angle of origin from the aorta, and the aorto-mesenteric distance of the superior mesenteric artery (SMA). Classical and aberrant branching patterns are described, including the artery rising from the thoracic segment of the aorta. Quantitative data are provided on the frequency of the celiacomesenteric, splenomesenteric, and hepatomesenteric trunks. Variants of the hepatic, right renal, and splenic branches originating from the SMA are discussed. Particular attention is given to the diameter of the abdominal aorta at the level of the SMA origin and the spatial relationship between the superior mesenteric, celiac trunk, and inferior mesenteric arteries. The anatomical variants of the arteries supplying the small intestine are described, including their quantitative parameters and specific features of the arcade anastomosis formation. Special focus is placed on the variant anatomy of the ileocolic, right colic, and middle colic arteries supplying the right colon. Morphometric data highlight the common, sex-specific, and individual angioarchitectonic features of these vessels. A wide range of variants concerning the origin, branching, trajectory, and distribution patterns of the branches of the SMA were noted, with some sex- and age-related characteristics traced. Understanding the topographic and morphometric characteristics of the SMA is crucial in clinical practice when planning a wide range of diagnostic and surgical interventions, as well as for applying modern interventional technologies. Simultaneously, the extensive anatomical variability of the SMA necessitates targeted research considering age, sex, and anatomical type in adults.

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About the authors

Ivan V. Gaivoronsky

Kirov Military Medical Academy; Saint Petersburg State University

Email: vmeda-nio@mil.ru
ORCID iD: 0000-0002-7232-6419
SPIN-code: 1898-3355

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Saint Petersburg; Saint Petersburg

Gennady I. Nichiporuk

Kirov Military Medical Academy; Saint Petersburg State University

Author for correspondence.
Email: vmeda-nio@mil.ru
ORCID iD: 0000-0001-5569-7325
SPIN-code: 3532-1203

MD, Cand. Sci. (Medicine), Associate Professor

Russian Federation, Saint Petersburg; Saint Petersburg

Maria G. Gaivoronskaya

Saint Petersburg State University; Almazov International Medical Research Center

Email: vmeda-nio@mil.ru
ORCID iD: 0000-0003-4992-9702
SPIN-code: 2357-5440

MD, Dr. Sci. (Medicine), Associate Professor

Russian Federation, Saint Petersburg; Saint Petersburg

Igor A. Klishevich

Kirov Military Medical Academy

Email: vmeda-nio@mil.ru
ORCID iD: 0009-0003-5863-4567
SPIN-code: 2805-1238
Russian Federation, Saint Petersburg

Andrey G. Nichiporuk

Kirov Military Medical Academy

Email: vmeda-nio@mil.ru
ORCID iD: 0009-0002-2269-6179
SPIN-code: 5438-3907
Russian Federation, Saint Petersburg

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2. Fig. 1. Parts of the vertebral column to determine the level of superior mesenteric artery origin.

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