Background: Catheterization of the inferior mesentery artery (IMA) during angiography can sometimes be difficult due to anatomic variations. Our study aimed to evaluate the relationship between abdominal aortic tortuosity (AAT) and the anatomy of the IMA root. Methods: In this retrospective study, a total of 45 patients were selected and 3 groups were divided using a qualitative method by visual estimation of vessel tortuosity. A quantitative method was performed by recording the patient age, tortuosity index, and features of the IMA root anatomy, including orifice level, vertical diameter, clockwise angle, and angulation. Pearson correlation coefficients (p < 0.05) were calculated to analyse the strength of the linear association between tortuosity and other variables. Results: The AAT index was significantly associated with age. When the abdominal aorta was tortuous, the IMA root was more likely to be distorted toward the convex side, with a larger angulation between the IMA root and the abdominal aorta. Conclusions: Our study provides information which could help clinicians plan endovascular interventions of IMA. When cannulation of the IMA appears to be difficult, a rotation of tip of the catheter to the convex side of the abdominal aorta and a less sharp looping of the catheter may be attempted.
