The sigmoid arteries - an imaging-based anatomical study with clinical implications.

Abstract

Background: The sigmoid arteries (SAs) are essential for supplying blood to the sigmoid colon and exhibit considerable anatomical variability in their number, origin, and branching patterns. A precise understanding of SA anatomy is crucial for colorectal surgical procedures, particularly in oncological and diverticular disease resections.

Materials and methods: A retrospective analysis was performed on 75 consecutive Polish patients who underwent abdominal computed tomography angiography (CTA) at the Radiology Department of Jagiellonian University Medical College between 2018 and 2022. The study assessed SA origin, diameter, cross-sectional area, and distance from the inferior mesenteric artery (IMA).

Results: The first SA most commonly originated directly from the IMA (69.01%), whereas the second and third SAs predominantly arose from the sigmoid trunk. The analysis of SA types, based on the Cirocchi et al. classification, revealed that Type 1 configurations were the most common, accounting for 50.70% of cases. Among them, Type 1B was the predominant subtype (35.21%). The median number of observed SAs per patient was 1, with a maximum of 6. The first SA had a median diameter of 1.97 mm at its origin, with a range from 0.70 mm to 3.32 mm. The distance from the origin of the IMA to the first SA exhibited a wide range, with a median of 52.76 mm and a maximum of 82.77 mm.

Conclusions: The sigmoid arteries, which serve as the primary source of blood supply to the sigmoid colon, exhibit significant variability in their origin and number of branches. The present study provides a detailed and comprehensive analysis of the morphometric characteristics and branching patterns of the sigmoid arteries, aiming to enhance current knowledge. This data may be particularly valuable for physicians, as it is clinically relevant to various colorectal surgical procedures, such as malignancy resections.