Importantly, the arcade, including the GDA-SMA (PDA arcade), SMA-IMA (
Riolan arcade or Drummond arcade), and SPA-left gastroepiploic artery, should be carefully attended to during the procedure.
Furthermore, an enlarged
riolan arcade resulted in an increased blood flow to the upper mesenteric artery from the lower mesenteric artery providing collateral circulation.
Two potential routes of collateral flow are present between the SMA and IMA, including the marginal artery of Drummond that courses peripherally along the mesenteric margin/reflection of the colon, and the Arc of
Riolan, which is located in the more central portions of the mesentery.
The contraction of
Riolan's muscle exerts pressure to the end part of the ductal system and acini and is beneficial to the delivery of the lipid to the lid margin [27].
[1] The disease entity itself had been described in 1767 by Gobbel, [2] although
Riolan [3] might have recognized it in 17th century.
When the IMA became narrow or even obstructed by atherosclerosis plaque, the flow from the superior mesenteric artery (SMA) via the arc of
Riolan (marginal artery) to the IMA compromises flow reserve to the small intestine, which result in the symptom of small bowel ischemia.
the superior mesenteric and inferior mesenteric arteries can supply each other in a bidirectional manner through
Riolan' s arterial arch [6]; b.
I continued down to another tributary, the
Riolan, for an even more sublime dip.
First, the inferior mesenteric artery is ligated at the root of the aorta so that various collateral vessels within the marginal branches and
Riolan's arch are not sacrificed.