Features of catheterization of the inferior mesenteric artery and its architecture in patients with colorectal cancer according to X-ray contrast angiography data

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Abstract

INTRODUCTION: The anatomy of the celiac trunk and superior mesenteric artery, due to their clinical significance, has been studied quite well both in abdominal surgery and oncology. At the same time, there is much less information about peculiarities of the structure and catheterization of the inferior mesenteric artery (IMA) in angiographic operations, which was the reason for studying this issue.

AIM: To study the architecture of the IMA and the peculiarities of its catheterization based on X-ray contrast angiography data.

MATERIALS AND METHODS: The study included 20 patients (13 men, 7 women; mean age (56.0 ± 7.0) years) with colorectal cancer and colorectal cancer metastases to regional lymph nodes, who underwent intra-arterial neoadjuvant/adjuvant therapy. X-ray endovascular intervention was performed using a Siemens Artis Zee device. In 10 patients, angiography was performed through the femoral access, in 10 patients — through a puncture of the brachial artery. The identified features of the structure of the IMA, were structured using a modified classification of H. Yada.

RESULTS: Type I of the IMA structure according to H. Yada was detected in 70%; type II — in 15%; type III — in 10%; type IV — in 5%. Basic morphometric parameters of the IMA were: diameter — (2.90 ± 0.67) mm, length to the level of separation of the first branch — (29.8 ± 15.9) mm, separation angle — (32.0 ± 7.4)°. The revealed structural features of the inferior mesenteric artery make access through the upper limb using an MPA catheter preferable.

CONCLUSION: Four variants of the structure of the IMA circulation according to H. Yada’s classification were confirmed, and its main morphometric parameters were established based on our clinical material. Access through the upper limb using an MPA catheter with the primary visualization of the IMA at the level of the fifth lumbar vertebra with subsequent pulling up and orientating the catheter tip toward the anterior wall of the left semicircle of the aorta is optimal for catheterization of the IMA and its branches.

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About the authors

Roman E. Kalinin

Ryazan State Medical University

Email: kalinin-re@yandex.ru
ORCID iD: 0000-0002-0817-9573
SPIN-code: 5009-2318

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Ryazan

Evgeny P. Kulikov

Ryazan State Medical University

Email: e.kulikov@rzgmu.ru
ORCID iD: 0000-0003-4926-6646
SPIN-code: 8925-0210

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Ryazan

Ivan N. Shanaev

Ryazan State Medical University

Email: c350@yandex.ru
ORCID iD: 0000-0002-8967-3978
SPIN-code: 5524-6524

MD, Dr. Sci. (Medicine)

Russian Federation, Ryazan

Nikolay A. Pronin

Ryazan State Medical University

Email: proninnikolay@mail.ru
ORCID iD: 0000-0002-6355-8066
SPIN-code: 4991-0918

MD, Cand. Sci. (Medicine)

Russian Federation, Ryazan

Olga V. Zotova

Ryazan Regional Clinical Oncologic Dispensary

Author for correspondence.
Email: zotova.olga97@yandex.ru
ORCID iD: 0009-0009-8318-6042
SPIN-code: 8338-5402
Russian Federation, Ryazan

Alexander V. Karpov

Ryazan State Medical University

Email: karpov145@yandex.ru
ORCID iD: 0000-0001-9635-9445
SPIN-code: 5907-1019
Russian Federation, Ryazan

Vladimir A. Yudin

Ryazan State Medical University

Email: vydin@yandex.ru
ORCID iD: 0000-0002-9955-6919
SPIN-code: 1463-2810

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Ryazan

Sergey A. Kovalev

N.N. Burdenko Voronezh State Medical University

Email: kovalev@okb.vrn.ru
ORCID iD: 0000-0001-6342-2209
SPIN-code: 4072-5292

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Voronezh

References

  1. Panina LYu, Zaytsev OV, Cherdantseva TM, et al. Experimental Reasons for the Use of Silver Polyacrylate in the Prevention and Treatment of Bleeding After Endoscopic Retrograde Cholangiopancreatography. Science of the Young (Eruditio Juvenium). 2024;12(2):175–182. doi: 10.23888/HMJ2024122175-182 EDN: HWSBXA
  2. Zaytsev OV, Ignatov IS, Ogorel'tsev AY, et al. Simultaneous Treatment of Multifocal Gastric and Sigmoid Colon Carcinoma from Laparoscopic Access: A Case Report. I.P. Pavlov Russian Medical Biological Herald. 2022;30(2):253–260. doi: 10.17816/PAVLOVJ82483 EDN: DPUCPW
  3. Kriger AG, Pronin NA, Dvukhzhilov MV, et al. Surgical glance at pancreatic arterial anatomy. Annals of HPB Surgery. 2021;26(3):112–122. doi: 10.16931/1995-5464.2021-3-112-122 EDN: NJEXAM
  4. Pronin NA. Dorsal pancreatic artery: incidence, morphometry, origin, course, branches. Siberian Scientific Medical Journal. 2024;44(3):29–40. doi: 10.18699/SSMJ20240303 EDN: JJNZUK
  5. Pronin NA. The splenic artery: origin, morphometry, topography of the vessel in relation to the pancreas, main pancreatic branches. Siberian Scientific Medical Journal. 2022;42(6):15–28. doi: 10.18699/SSMJ20220602 EDN: HFXSGG
  6. Sekisova EV, Pavlov AV, Pronin NA, et al. Variants of Mutual Arrangement of Parts of Human Pancreas According to Computed Tomography Data. I.P. Pavlov Russian Medical Biological Herald. 2024;32(3):467–474. doi: 10.17816/PAVLOVJ321391 EDN: AOWEQE
  7. Gaivoronsky IV, Bykov PM, Gaivoronskaya MG. Comparative characteristics of the morphometric parameters of the abdominal part of aorta and its unpaired branches in the age and sex aspects. Bulletin of the Russian Military Medical Academy. 2019;21(2):37–42. doi: 10.17816/brmma25916 EDN: XDRPTK
  8. Bykov PM, Krikun EN. Anatomo-topographic features of the inferior mesenteric artery. Morphology. 2019;155(2):53. doi: 10.17816/morph.102401 EDN: QWAMEU
  9. Gangam RR, Lakmala V. A morphometric study of branching pattern of inferior mesenteric artery. Int J Pharma Bio Sci. 2016;7(2):19–25. Available from: https://www.ijpbs.net/abstract.php?article = NTAyMQ = = . Accessed: 13.10.2024.
  10. Niklas N, Malec M, Gutowski P, et al. Effectiveness of Inferior Mesenteric Artery Embolization on Type II Endoleak-Related Complications after Endovascular Aortic Repair (EVAR): Systematic Review and Meta-Analysis. J Clin Med. 2022;11(18):5491. doi: 10.3390/jcm11185491 EDN: TDASTT
  11. Zeng S, Wu W, Zhang X, et al. The significance of anatomical variation of the inferior mesenteric artery and its branches for laparoscopic radical resection of colorectal cancer: a review. World J Surg Oncol. 2022;20(1):290. doi: 10.1186/s12957-022-02744-6 EDN: ABHLNK
  12. Olshansky MS, Glukhov AA, Zhdanov AI, et al. Rationale for the endovascular treatment of rectal cancer. Bulletin of Experimental and Clinical Surgery. 2012;5(4):644–647. EDN: PFEXEX
  13. Kondov S, Dimov A, Beyersdorf F, et al. Inferior mesenteric artery diameter and number of patent lumbar arteries as factors associated with significant type 2 endoleak after infrarenal endovascular aneurysm repair. Interact Cardiovasc Thorac Surg. 2022;35(1):ivac016. doi: 10.1093/icvts/ivac016 EDN: UGHUKP
  14. Kalinin RE, Kulikov EP, Verkin NI, et al. Intra-arterial chemoembolization as a component of neoadjuvant treatment of rectal cancer. Literature review. Siberian Scientific Medical Journal. 2024;44(5):6–18. doi: 10.18699/SSMJ20240501 EDN: EBCRMF
  15. Zaitsev OV, Kopeykin AA, Surov DE, et al. Balloon Angioplasty and Stenting of Superior Mesenteric Artery in Chronic Intestinal Ischemia Associated with Decompensated Chronic Heart Failure (Clinical Case Report). I.P. Pavlov Russian Medical Biological Herald. 2024;32(3):491–498. doi: 10.17816/PAVLOVJ303673 EDN: QAJISF
  16. Schnayder PA. Tekhniki endovaskulyarnykh manipulyatsiy. Provodniki i katetery v endovaskulyarnoy khirurgii. Moscow: GEOTAR-Media; 2024. (In Russ). EDN: TVJJXV
  17. Yada H, Sawai K, Taniguchi H, et al. Analysis of vascular anatomy and lymph node metastases warrants radical segmental bowel resection for colon cancer. World J Surg. 1997;21(1):109–115. doi: 10.1007/s002689900202 EDN: FPCZGZ
  18. Zhang C, Li A, Li F. [The angiographic anatomy of the inferior mesenteric artery in elder]. Zhonghua Wai Ke Za Zhi. 2020;58(2):119–124. (In Chinese) doi: 10.3760/cma.j.issn.0529-5815.2020.02.009
  19. Cirocchi R, Randolph J, Cheruiyot I, et al. Systematic review and meta-analysis of the anatomical variants of the left colic artery. Colorectal Dis. 2020;22(7):768–778. doi: 10.1111/codi.14891
  20. Murono K, Kawai K, Kazama S, et al. Anatomy of the inferior mesenteric artery evaluated using 3-dimensional CT angiography. Dis Colon Rectum. 2015;58(2):214–219. doi: 10.1097/dcr.0000000000000285
  21. Ke J, Cai J, Wen X, et al. Anatomic variations of inferior mesenteric artery and left colic artery evaluated by 3-dimensional CT angiography: Insights into rectal cancer surgery — A retrospective observational study. Int J Surg. 2017;41:106–111. doi: 10.1016/j.ijsu.2017.03.012
  22. Sinkeet S, Mwachaka P, Muthoka J, Saidi H. Branching pattern of inferior mesenteric artery in a black African population: a dissection study. ISRN Anat. 2012;2013:962904. doi: 10.5402/2013/962904
  23. Calafiore AM, Di Giammarco G, Teodori G, et al. Myocardial Revascularization with Multiple Arterial Grafts. Asian Cardiovascular and Thoracic Annals. 1995;3(3–4):95–102. doi: 10.1177/021849239500300402
  24. Van Tonder JJ, Boon JM, Becker JHR, van Schoor A-N. Anatomical considerations on Sudeck's critical point and its relevance to colorectal surgery. Clin Anat. 2007;20(4):424–427. doi: 10.1002/ca.20417
  25. Rait FK, Eskallon JM, Kukir M, editors; Ryabov AB, translator. Rukovodstvo po operativnoy onkologii. Moscow: GEOTAR-Media; 2023. (In Russ.)
  26. Hitaryan AG, Miziev IA, Glumov EE, et al. Features of endovascular angioarchitectonics of the inferior mesenteric artery branches and their relevance to surgical coloproctology. Annaly Hirurgii. 2013;(6):38–42. EDN: SBYGDH
  27. Zhang C, Li A, Luo T, et al. Evaluation of characteristics of left-sided colorectal perfusion in elderly patients by angiography. World J Gastroenterol. 2020;26(24):3484–3494. doi: 10.3748/wjg.v26.i24.3484 EDN: NFLPST
  28. Ding Y, Zhao B, Niu W, et al. Assessing anatomical variations of the inferior mesenteric artery via three-dimensional CT angiography and laparoscopic colorectal surgery: a retrospective observational study. Sci Rep. 2024;14(1):6985. doi: 10.1038/s41598-024-57661-3 EDN: OXQTQD
  29. Zakharchenko AA, Vinnik YuS, Galkin EV, et al. Rol' rentgenanatomii nizhney bryzheyechnoy arterii pri operatsiyakh po povodu raka pryamoy kishki. Koloproktologiya. 2011;(S3):67–70. (In Russ.) EDN: WCMOSL
  30. Balcerzak A, Kwaśniewska O, Podgórski M, et al. Types of inferior mesenteric artery: a proposal for a new classification. Folia Morphol (Warsz). 2021;80(4):827–838. doi: 10.5603/fm.a2020.0115 EDN: GEULNB

Supplementary files

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2. Fig. 1. Type I structure of inferior mesenteric artery: a — schematic, b — angiogram.

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3. Fig. 2. Type II structure of inferior mesenteric artery: a — schematic, b — angiogram.

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4. Fig. 3. Type III structure of inferior mesenteric artery: a — schematic, b — angiogram.

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5. Fig. 4. Type IV structure of inferior mesenteric artery: a — schematic, b — angiogram.

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