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Introduction and Hypothesis The obturator artery (ObA) is described as a branch of the anterior division of the internal iliac artery. It arises close to the origin of the umbilical artery, where it is crossed by the ureter. The main goal of the present study was to create an anatomical map of the ObA demonstrating the most frequent locations of the vessel’s origin and course. Methods In May 2022, an evaluation of the findings from 75 consecutive patients who underwent computed tomography angiography studies of the abdomen and pelvis was performed. Results The presented results are based on a total of 138 arteries. Mostly, ObA originated from the anterior trunk of the internal iliac artery (79 out of 138; 57.2%). The median ObA diameter at its origin was found to be 3.34 mm (lower quartile [LQ] = 3.00; upper quartile [UQ] = 3.87). The median cross-sectional area of the ObA at its origin was found to be 6.31 mm 2 (LQ = 5.43; UQ = 7.32). Conclusions Our study developed a unique arterial anatomical map of the ObA, showcasing its origin and course. Moreover, we have provided more data for straightforward intraoperative identification of the corona mortis through simple anatomical landmarks, including the pubic symphysis. Interestingly, a statistically significant difference ( p  < 0.05) between the morphometric properties of the aberrant ObAs and the “normal” ObAs originating from the internal iliac artery was found. It is hoped that our study may aid in reducing the risk of serious hemorrhagic complications during various surgical procedures in the pelvic region.

The internal iliac artery arises as a terminal extension of the common iliac artery and supplies blood to the pelvic region . This study aims to identify the anatomic variations of the internal iliac artery (IIA) in a Mexican population sample. This is a retrospective cross-sectional observational study. A total of 81 angiographies via the femoral artery approach performed on patients undergoing various medical procedures were included. Variations in the IIA branching patterns were identified by evaluating the angiographic images and grouped according to Adachi’s classification into five types (I–V). A total of 139 hemipelvises were analyzed (78 right and 61 left). The frequencies of each type of variation were as follows: Type I (71.2%), Type II (10.79%), Type III (0 cases), Type IV (0.7%), Type V (12.94%), and unclassified (4.31%). The most frequent anatomical variants of the IIA in the western Mexican population sample were Type I, followed by Types V and II. Even though Type V is rare in most populations, it was the second most frequent variant in this study. Understanding the variants of the IIA branching pattern is necessary for performing invasive procedures in the pelvic region with precision and minimizing complications.

BACKGROUND: The internal iliac artery (IIA) originates from the common iliac artery at the level of the sacroiliac joint and bifurcates between the L5 and S1 vertebrae. The aim of the present meta-analysis was to demonstrate the most up-to-date and evidence-based data regarding the general anatomy of the IIA, including their variations, length, and diameter. MATERIALS AND METHODS: Major online medical databases such as PubMed, Scopus, Embase, Web of Science, Cochrane Library, and Google Scholar were searched to find all studies considering the anatomy of the IIA. Eligibility assessment and data extraction stages were performed. RESULTS: In the general population the pooled prevalence of Type I (The superior gluteal artery arises independently with the inferior gluteal and internal pudendal arteries arising from a common trunk which dividing inside [Type IA] or outside [Type IB] pelvic cavity) was found to be 56.57% (95% CI: 53.00–60.10%). The pooled mean length of the IIA was 39.95 mm (SE = 1.79) in the overall population. The pooled mean diameter of the IIA was found to be 6.86 mm (SE = 0.27). CONCLUSIONS: The IIA is responsible for supplying most of the structures located in the pelvis. Hence, it is crucial to be aware of the possible variants of the said vessel. The results presented in our study may be highly significant in various surgical procedures performed in that region.

Introduction and Hypothesis The internal iliac artery stands as the main blood supplier of the pelvis, serving as the primary source of blood for the pelvic viscera while also nourishing the musculoskeletal framework within. The arterial anatomy of the pelvis exhibits a vast array of variations, especially regarding the branching pattern of the internal iliac arteries. The posterior division of the internal iliac artery (PDIIA) may also have variable topography, especially regarding the location of its origin in the pelvic region. Methods A retrospective study was carried out to determine the anatomical variations, prevalence, and morphometric data of the PDIIA and its branches. A total of 75 computed tomography angiographies were analyzed. Results The most prevalent branch of the PDIIA was the superior gluteal artery, as it was present in 114 of the studied cases (77.03%). The median diameter of the PDIIA at its origin was 6.66 mm. The median cross-sectional area of the PDIIA at its origin was set to be 34.59 mm 2 . Conclusion Our study highlights the critical significance of understanding the PDIIA and its branches in surgical interventions aimed at managing pelvic hemorrhage. The present study provides valuable insights into the precise localization and characteristics of the PDIIA and its branches, which are essential for surgical procedures targeting specific vessels to control bleeding effectively. Owing to the high level of variability of the branching pattern of the PDIIA, a novel classification system consisting of six types was created.

PurposeMeasure out of the standard interval in the aorta diameter is a clue for aortic aneurysm or hypoplasia. Pediatric studies focusing specifically on the normal diameter of the abdominal aorta (AA) were limited in the literature. Therefore, the main goal of this work was to determine changes in the effective diameter of AA in healthy children aged 1–18 years for diagnosis of vascular diseases.MethodsThis retrospective work focused on abdominopelvic computed tomography views of 180 children (sex: 90 males / 90 females, average age: 9.50 ± 5.20 years) without any abdominopelvic disease to measure diameters of AA, common iliac artery (CIA), external iliac artery (EIA), and first lumbar vertebra (L1).ResultsVessel and vertebra diameters increased in pediatric subjects between 1 and 18 years (p < 0.001). Considering pediatric age periods, vessel diameters increased steadily, but L1 diameter showed an irregular growth pattern between age periods. All parameters were greater in males than females (p < 0.05), except from effective diameters of AA over the coeliac trunk (p = 0.084) and over the renal artery (p = 0.051). The ratios of diameters of vessels to L1 increased depending on ages between 1 and 18 years. Considering pediatric age periods, the ratios increased from infancy period to postpubescent period in irregular pattern; however, the ratios for right and left CIA, and AA over the aortic bifurcation did not alter after late childhood period. All ratios for males were similar to females (p > 0.05).ConclusionOur age-specific ratios may be beneficial for surgeons and radiologists for the diagnosis of vascular disorders such as aortic aneurysm.

Introduction The anterior division of the internal iliac artery (ADIIA) is a crucial vascular structure that supplies blood to the pelvic organs, perineum, and gluteal region. The present study demonstrates practical data concerning the anatomy of the ADIIA and its branches. It is hoped that the results of the current study may aid in localizing the pelvic arteries effectively. Methods The present study is a retrospective analysis that was carried out to determine the anatomical variations, prevalence, and morphometric data of the ADIIA and its branches. Ultimately, 148 ADIIAs from 73 patients met the necessary criteria and were evaluated in 45 categories. Results The most prevalent branch of the ADIIA was found to be the internal pudendal artery, as it was present in 134 of the studied cases (90.5%). The most common first branch of the ADIIA was found to be the umbilical artery (48.5%), whereas the most common last branch of the ADIIA was found to be the inferior gluteal artery (68.4%). The median distance between the origin of the ADIIA and the origin of the uterine artery was found to be 12.00 mm (LQ = 7.49; HQ = 18.63). The median diameter of the ADIIA at its origin was found to be 5.76 mm (LQ = 4.80; HQ = 6.45), whereas the median cross-sectional area at the same point was set to be 24.77 mm2 (LQ = 17.65; HQ = 31.95). Conclusion It is hoped that the results of the present study will assist in the localization of the branches of the ADIIA in cases of pelvic hemorrhage and during various pelvic surgeries, including laparoscopic hysterectomies.

PurposeCatheter angiography remains essential to detect, characterize, and treat many vascular, traumatic, and neoplastic conditions affecting the pelvis, but the angiographic literature rarely mentions the common iliac artery (CIA) and its branches. The “normal” branches of the CIA principally consist of subangiographic rami supplying neighboring structures. Larger branches participate in the vascularization of the psoas muscle and the ureter. Less often, the CIA provides anomalous branches that complement or replace critical neighboring vessels. This study investigates the prevalence, type, and clinical relevance of CIA branches detectable during pelvic angiography.MethodsThis study analyzes the prevalence of CIA branches in 100 consecutive angiograms that included bilateral CIA injections as well as selective catheterizations of the median sacral artery, both L4 ISAs, and both internal iliac arteries. CIA branches were classified as normal (i.e., neither supplementing nor replacing a normal artery), accessory (i.e., supplementing a normal artery), or aberrant (i.e., replacing a normal artery).ResultsForty-three branches arose from 38 CIAs (19% of CIAs) in 30 patients (30% of patients), including 20 normal branches (46.5%), 21 aberrant branches (48.8%), and 2 accessory branches (4.7%). Each of the 15 patients with aberrant branches had at least one anomalous vessel capable of providing a radicular or radiculomedullary artery.ConclusionsCIA branches were present in 30% of patients undergoing spinal angiography. While most normal branches were diminutive and clinically irrelevant, CIAs also provided vessels able to vascularize pelvic and vertebral structures, including the spinal cord or a spinal vascular malformation in 16% of cases. Our study therefore confirms that CIA injections represent an essential component of pelvic and spinal angiography.

PurposeThe tensor fasciae latae (TFL) muscle is supplied by the lateral femoral circumflex artery (LCFA), arising from the deep femoral artery. However, it has been noted that there is also a consistent vascular anastomotic network. The aim of this study was to describe the accessory vascularization of the TFL muscle through a descriptive anatomical study, in order to hypothesize the feasibility of harvesting a TFL flap in the event of an injury to the main pedicle. In addition, we illustrate this hypothesis with a successful clinical case of Scarpa freconstruction following ligature of the deep femoral artery.MethodsThe description of the accessory vascularization was obtained by injecting dye into seven lateral femoral circumflex arteries (LCFA), six superficial circumflex iliac arteries (SCIA), and three inferior gluteal arteries (IGA).ResultsThe TFL muscle was vascularized primarily by the LCFA. A vascular anastomotic network with the SCIA and the IGA was observed. After selective injection to the SCIAs and IGAs, the subsequent injection to the LCFA showed a diffusion of the TFL skin paddle with a perforasome overlapping between the different vascular territories.ConclusionThe ascending branch of the lateral femoral circumflex plays a dominant role in the vascularization of the TFL muscle. As a result of a periarticular anastomotic network of the hip, this artery establishes several connections with the proximal arteries. Consequently, in cases where blood flow through the LCFA is interrupted, it should be equally possible to harvest the TFL flap through its accessory vascularization.

Endovascular methods for stroke treatment have become increasingly popular in recent years and continue to be improved. Pigs serve as in vivo models in endovascular stroke research for device testing and training purposes. Due to a network of small vessels between the cerebral and intracranial arteries, called rete mirabile, catheterization of the brain-supplying arteries in pigs is impossible. Alternatively, various porcine arteries can be used. Aachen minipigs have become more popular in the last years, but specific data on their vascular diameters are limited to the forelimb arteries. Therefore, the aim of our study was to assess diameters of porcine hind limb arteries in eight female Aachen minipigs (weight of 47.08 kg ±  4.58 kg and age of 17 to 21 months), focusing on the internal iliac artery, external iliac artery, femoral artery, profunda femoris artery, popliteal artery, caudal tibial artery, cranial tibial artery, and sacral median artery, and to compare these diameters with diameters of human brain-supplying arteries. Measurements of artery diameters were conducted during experimental digital subtraction angiographies of a superordinate endovascular study. We found similarities between diameters of porcine hind limb arteries and human brain-supplying arteries: the porcine cranial tibial artery, sacral median artery, caudal tibial artery, popliteal artery, and profunda femoris artery are suitable for modelling human arteries. Our work may serve as a tool for planning and conducting interventional experiments involving Aachen minipigs and may therefore lead to reduced animal numbers according to the 3Rs (Replacement, Reducement, Refinement) from Russell and Burch.

PurposeThe aim of the study was to determine the flexion point’s location of the ilio-femoral arterial axis and its angulation.Materials and methodsThirty-seven dynamic digital subtraction angiographies were analyzed and were included in the current study. Different lengths were measured, based on specific anatomical landmarks: the origin of the external iliac artery, the inguinal ligament and the bifurcation of the femoral artery. These lengths were measured in extension and during flexion of the hip in order to determine the flexion point of the artery.ResultsIn extension, some physiological angulations of the external iliac artery were measured.During flexion of the hip joint, the distance from the kink point to the bifurcation of the common iliac artery was respectively 82 ± 21 mm (range 48–116) on the right side and 95 ± 20 mm (range 59–132) on the left side. The distance from the kink point to the inguinal ligament was respectively 38 ± 40 mm (range 12–138) on the right side and 26 ± 23 mm (range 8–136) on the left side. The distance from the kink point to the bifurcation of the femoral artery was respectively 45 ± 29 mm (range 15–107) on the right side and 27 ± 12 mm (range 10–66) on the left side. During flexion, the angulation of the flexion point of the ilio-femoral axis was 114 ± 18° (range 81–136°).ConclusionsThe flexion point was located cranially to the inguinal ligament and below the departure of the external iliac artery.