Middle Colic Artery Arising from the Coeliac Axis: Implications for Endovascular Surgery

We report the rare anatomical variant of the middle colic artery arising from the coeliac axis in a patient with symptoms of chronic mesenteric ischaemia. The anatomy is illustrated by 2D and 3D reconstructed images from contrast-enhanced CT scanning. We discuss the importance of recognising this anatomical variant, which has major implications for endovascular surgical planning. There are also significant risks if this variant anatomy is not recognised and the middle colic artery is inadvertently sacrificed.