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Positional relationships among the celiac trunk, superior mesenteric artery, and renal artery observed from the intravascular space

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Abstract

Purpose

To clarify the positional relationships among the celiac trunk (CT), the superior mesenteric artery (SMA), and the renal artery (RA) observed from the intravascular space to facilitate angiography.

Methods

After excluding six cadavers in which anatomic variation was found in the CT or SMA and four cadavers in which a curvature of 5° or more was observed in the aorta from 30 Japanese donor cadavers, we used the abdominal aortas of the remaining 20 cadavers as specimens. We made an incision in the maximum longitudinal diameter of the left RA (Lt. RA) and acquired an image of the intravascular space using a digital camera. The distance between the inferior borders of each vessel was used as the hypotenuse of a right-angled triangle. Lines parallel to the longitudinal diameter of the aorta and those parallel to the transverse diameter of the right-angled triangle were measured by a computer and expressed as relative distance indexes using the transverse diameter of the aorta at the Lt. RA level as a reference point.

Results

The transverse diameter of the aorta was 20.1 ± 2.9 mm, and the relative distance indexes for longitudinal/transverse lines between each vessel were 1.61/0.35 between Lt. RA and CT, 0.84/0.48 between Lt. RA and SMA, and 0.78/0.13 between CT and SMA. The angle between the transverse axis of the abdominal aorta and the linear line connecting CT and SMA was 80.2° ± 9.4°. The branching point of CT in relation to SMA was located at the upper left in 80 % (n = 16), on the same line in 15 % (n = 3), and at the upper right in 5 % (n = 1) of the subjects.

Conclusions

The relative distance indexes determined in this study will facilitate navigation during catheter insertion, particularly for those with little angiography experience, and thus reduce patient risk.

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Acknowledgments

The authors thank Drs. Ning Qu, Hayato Terayama, Shuichi Hirai, Takayoshi Miyaki, and Ms. Yuki Ogawa for their kind help in preparing this manuscript. The authors are indebted to Dr. Atsuko Kimura (PhD) and Associate Professor Edward F. Barroga (PhD) of the Department of International Medical Communications of Tokyo Medical University for their editorial review of this manuscript.

Conflict of interest

The authors declare that they have no conflict of interest associated with this study.

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Authors and Affiliations

  1. Department of Anatomy, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo, 160-8402, Japan

    Tetsuya Takahashi & Masahiro Itoh

  2. Graduate School of Health Science, Teikyo Heisei University, 2-51-4 Higashiikebukuro, Toshima-ku, Tokyo, 170-8445, Japan

    Kyoko Takeuchi

  3. Department of Emergency and Critical Care Medicine, Yokohama City Minato Red Cross Hospital, 3-12-1 Shin-yamashita, Naka-ku, Yokohama, Kanagawa, 231-8682, Japan

    Toshitaka Ito

Authors
  1. Tetsuya Takahashi
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  2. Kyoko Takeuchi
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  3. Toshitaka Ito
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  4. Masahiro Itoh
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Correspondence to Tetsuya Takahashi.

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Takahashi, T., Takeuchi, K., Ito, T. et al. Positional relationships among the celiac trunk, superior mesenteric artery, and renal artery observed from the intravascular space. Surg Radiol Anat 35, 411–417 (2013). https://doi.org/10.1007/s00276-012-1054-4

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  • DOI: https://doi.org/10.1007/s00276-012-1054-4

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