To review the classical anatomical description of the middle rectal artery (MRA). To describe the prevalence and radiologic anatomy of the MRA using angio CT and Digital Subtraction Angiography (DSA) based on a series of 167 male patients who underwent pelvic selective arterial embolization for varied reasons.

According to classical anatomical descriptions, the midle rectal artery (MRA) is frequently described as a constant collateral vesselthat frequently arises from the anterior divisionof the internal iliac artery, supplying the middleand inferior parts of the rectum. Cadaveric studies focusing on the arterial supply to the rectum have shown the MRA to be present in only 12% - 56.7% of the specimens,and that the blood-supply derived from the hypogastricarteries was minor, with the predominant blood-supplyderiving from the superior rectal artery.Recently, other cadaveric studies have shown that...

Procedure details Between October 2010 and February 2012, 167 male patients (mean age 64.7 years, range 47 – 81 years) underwent selective pelvic arterial embolization to control bleeding due to pelvic vesical, prostatic or rectal malignancies or to control lower urinary tract symptoms in patients with prostate enlargement. All patients underwent Angio CT previously to DSA in order to evaluate pelvic vascular anatomy and plan treatment. Middle rectal arteries were identified and classified according to origin, trajectory, termination and relationship with surrounding arteries. Imaging findings:...

Using Angio-CT and DSA we found an MRA prevalence of 35.9%. MRAs may have an independent origin from the neighboring arteries or a common origin with the prostatic arteries. The presence and radiologic anatomy of MRAs may be important for rectal surgeries and interventional radiology procedures.

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