Sampson's artery: anatomical, surgical and radiologic implications.

purposeSampson’s artery (SA), the artery of the round ligament, is a small vessel coursing alongside the round ligament of the uterus. The SA has significant clinical implications, particularly in obstetrics, gynecology, radiology, and general surgery. This study aims to synthesize current anatomical, embryological, and clinical evidence regarding SA and clarify its relevance for surgeons, radiologists, and anatomists.

methodsA structured search of PubMed and Google Scholar was performed using the terms “Sampson’s artery,” “artery of the round ligament,” and “round ligament artery.” Publications describing anatomical, radiological, embryological, or surgical findings were included without year restriction. Case reports, imaging studies, and reviews were analyzed for anatomic origin, course, variations, and clinical outcomes. A total of 88 articles were retrieved, and 33 met the inclusion criteria.

resultsSampson’s artery most often arises from the inferior epigastric artery or external iliac artery. It anastomoses with a branch of the uterine artery and contributes to the utero-ovarian anastomosis. Its caliber may increase during pregnancy or pelvic pathology, producing collateral flow that can contribute to postpartum hemorrhage, placenta accreta, leiomyoma rupture, or postoperative hemoperitoneum after hernia repair. Radiologically, persistent bleeding after uterine artery embolization frequently involves this vessel. Awareness remains limited among surgeons and trainees.

conclusionAlthough small, SA has disproportionate surgical and radiologic importance. Awareness of the SA as a possible source of persistent hemorrhage is essential for improving outcomes in pelvic and gynecologic procedures. Comprehensive preoperative planning and refinement of surgical and radiologic approaches can further minimize SA-related complications.