Corona Mortis : anatomical and surgical description on 60 cadaveric hemipelvises

ABSTRACT Objective: to report the prevalence of arterial corona mortis and to describe its surgical and clinical applicabilities. Methods: We dissected 60 hemipelvises (50 men and 10 women) fixed in a 10% formalin solution for the purpose of gathering information on corona mortis. We measured the caliber and length of the obturator artery and its anastomotic branch with the aid of a digital caliper and submitted the data to statistical analyzes and comparisons with the GraphPad Prism 6 software. Results: arterial corona mortis was present in 45% of the studied sample. The most common origin of the obturator artery was the internal iliac artery; however, there was one exceptional case in which it originated from the femoral artery. The caliber of the anastomotic branch was on average 2.7mm, whereas the caliber of the obturator artery was 2.6mm. Conclusion: the vascular connections between the obturator, internal iliac, external iliac and inferior epigastric arterial systems are relatively common over the upper pubic branch. The diameter and a trajectory of the anastomotic artery may vary. Thus, iatrogenic lesions and pelvic and acetabular fractures can result in severe bleeding that puts the patient’s life at risk.

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Hemorrhage Secondary to Pelvic Fracture: Coil Embolization of an Aberrant Obturator Artery

Journal of Endovascular Therapy ◽

10.1177/152660280301000341 ◽

2003 ◽

Vol 10 (3) ◽

pp. 676-680 ◽

Cited By ~ 10

Author(s):

Bernd Daeubler ◽

Suzanne E. Anderson ◽

Michael Leunig ◽

Jürgen Triller

Keyword(s):

Iliac Artery ◽

Coil Embolization ◽

Internal Iliac Artery ◽

Pelvic Ring ◽

External Iliac Artery ◽

Vascular Anomaly ◽

Abdominal Ultrasound ◽

Obturator Artery ◽

Corona Mortis ◽

Internal Iliac

Purpose: To describe the anatomical variations of the corona mortis, a vascular anomaly that may lead to dangerous hemorrhage and possible death. Case Report: A 46-year-old male cyclist was involved in a collision with a car, during which he sustained fractures to the left ribs and pelvic ring. Abdominal ultrasound imaging demonstrated a large (12×6×7 cm) nonhomogeneous mass ventral to the bladder, suggestive of a hematoma, which was confirmed on computed tomography. During angiography, 2 branches of the internal iliac artery were identified as sources of the bleeding; these were successfully embolized with microcoils, but the bleeding continued. Examination of the external iliac system found a lacerated aberrant obturator artery arising from the inferior epigastric branch of the external iliac artery, a condition known as the corona mortis. Additional embolization quelled the hemorrhage. Conclusions: Coil embolization of the internal iliac artery branches is very effective in managing hemorrhage due to pelvic fractures, but variations in the origin of the obturator artery from the internal or external iliac artery may be additional sources of bleeding.

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Pelvic collateral pathway during endovascular aortoiliac aneurysm repair with internal iliac artery interruption: a retrospective observational study

BMC Cardiovascular Disorders ◽

10.1186/s12872-020-01764-y ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Satoshi Nishi ◽

Shogo Hayashi ◽

Takuya Omotehara ◽

Shinichi Kawata ◽

Yoshihiro Suematsu ◽

...

Keyword(s):

Iliac Artery ◽

Internal Iliac Artery ◽

Image Analysis System ◽

Circumflex Artery ◽

Obturator Artery ◽

Collateral Arteries ◽

Aortoiliac Aneurysm ◽

Internal Iliac ◽

Collateral Pathway ◽

Aneurysm Repair

Abstract Background Ipsilateral branches of the deep femoral artery (DFA) are qualitatively identified as collateral arteries based on angiography after internal iliac artery (IIA) interruption. The purpose of this study was to quantitatively identify the major collateral pathway after unilateral IIA interruption during endovascular aortoiliac aneurysm repair to preserve the pelvic circulation and reduce the risk of ischemic complications. Methods The study population included 28 patients (mean age 76.3 years) with aortoiliac aneurysm who underwent endovascular aneurysm repair with unilateral IIA interruption from August 2012 to January 2020. The diameters of the bilateral preoperative and postoperative DFA, lateral femoral circumflex artery (LFCA), medial femoral circumflex artery (MFCA) and obturator artery (ObA) were measured on contrast-enhanced computed tomography using a 3-dimensional image analysis system. The measured values were evaluated and analyzed with a repeated measures two-way analysis of variance and Dunnett’s test. Results The postoperative diameters of the MFCA (P = 0.051) and ObA (P = 0.016) were observed to be larger than the preoperative diameters. Such increases in the MFCA (P < 0.001) and ObA (P < 0.001) diameters were only found to be significant on the unilateral side of the IIA interruption, and the diameter of the ipsilateral LFCA (P < 0.001) was also found to have significantly increased in size. However, no significant arterial extension was found on the contralateral side. Conclusions The ipsilateral MFCA-ObA pathway might therefore be a major collateral pathway arising from the DFA to preserve pelvic circulation after unilateral IIA interruption.

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Anomalous Origin of Obturator Artery from the Internal Iliac Artery

International Journal of Morphology ◽

10.4067/s0717-95022007000300028 ◽

2007 ◽

Vol 25 (3) ◽

Cited By ~ 10

Author(s):

Dinesh Kumar ◽

Gayatri Rath

Keyword(s):

Iliac Artery ◽

Internal Iliac Artery ◽

Anomalous Origin ◽

Obturator Artery ◽

Internal Iliac

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Variation in the origin of right obturator artery - A case report

Journal of Health and Allied Sciences NU ◽

10.1055/s-0040-1703921 ◽

2015 ◽

Vol 05 (03) ◽

pp. 105-106

Author(s):

Rani Nallathamby ◽

Ramakrishna Avadhani ◽

Sivarama C. H. ◽

Meril Ann Soman ◽

Meera Jacob

Keyword(s):

Case Report ◽

Iliac Artery ◽

High Frequency ◽

Internal Iliac Artery ◽

External Iliac Artery ◽

Anomalous Origin ◽

Obturator Artery ◽

Anterior Trunk ◽

Internal Iliac

AbstractMost commonly, the Obturator artery arises from the anterior trunk of internal iliac artery. However, origin of the Obturator artery from external iliac artery was reported at 25% by Missankov et al. [3], 1.1% by Bergman et al. [1], 1.3% by Jakubowicz and Czerniawska- Grzesinska [2].Due to its high frequency of variations in course and origin, Obturator artery had drawn the attention of anatomists, surgeons and radiologists. In this case report, we are presenting an anomalous origin of right Obturator artery from right external iliac artery. The knowledge of this variation is important anatomically, radiologically and surgically.

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Infected femoral artery pseudoaneurysm in drug addicts: The beneficial use of the internal iliac artery for arterial reconstruction

Journal of Vascular Surgery ◽

10.1016/j.jvs.2006.11.014 ◽

2007 ◽

Vol 45 (3) ◽

pp. 498-504 ◽

Cited By ~ 34

Author(s):

Chris Klonaris ◽

Athanasios Katsargyris ◽

Anastasios Papapetrou ◽

George Vourliotakis ◽

Sotiris Tsiodras ◽

...

Keyword(s):

Femoral Artery ◽

Iliac Artery ◽

Internal Iliac Artery ◽

Drug Addicts ◽

Arterial Reconstruction ◽

Artery Pseudoaneurysm ◽

Beneficial Use ◽

Internal Iliac

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Importance of Both Internal and External Iliac Artery Interrogation in Pelvic Trauma as Evidenced by Hemorrhage from Bilateral Corona Mortis with Unilateral Aberrant Origin off the External Iliac Artery

Case Reports in Radiology ◽

10.1155/2019/6734816 ◽

2019 ◽

Vol 2019 ◽

pp. 1-4

Author(s):

Michael Herskowitz ◽

James Walsh ◽

Meghan Lilly ◽

Kimberly McFarland

Keyword(s):

Iliac Artery ◽

External Iliac Artery ◽

Hemodynamic Instability ◽

Pelvic Trauma ◽

Obturator Artery ◽

Iliac Arteries ◽

Corona Mortis ◽

Internal Iliac ◽

Blunt Pelvic Trauma ◽

Internal Iliac Arteries

Transcatheter angiography and embolization has long been recognized as the gold standard for patients with hemodynamic instability secondary to blunt pelvic trauma. While often the bleeding source can be readily localized based on the distribution of extravasation on preprocedural Computed Tomographic Angiography, one should be cautious in assessment for aberrant anatomy. A variant obturator artery originating from the inferior epigastric branch of the external iliac artery is commonly referred to as the corona mortis. We present a case of blunt pelvic trauma in which a patient demonstrated extravasation in the anterior distributions of both internal iliac arteries. Following embolization of bilateral internal iliac arteries, identification and embolization of bilateral corona mortis branches was crucial to achieving hemodynamic stability in this patient.

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The inferior epigastric artery arising from the internal iliac artery via a common trunk with the obturator artery

Anatomy & Cell Biology ◽

10.5115/acb.2012.45.4.285 ◽

2012 ◽

Vol 45 (4) ◽

pp. 285 ◽

Cited By ~ 3

Author(s):

Hyung-Sun Won ◽

Hyung-Jin Won ◽

Chang-Seok Oh ◽

Seung-Ho Han ◽

In-Hyuk Chung ◽

...

Keyword(s):

Iliac Artery ◽

Internal Iliac Artery ◽

Common Trunk ◽

Inferior Epigastric Artery ◽

Obturator Artery ◽

Epigastric Artery ◽

Internal Iliac

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Regarding “Infected femoral artery pseudoaneurysm in drug addicts: The beneficial use of the internal iliac artery for arterial reconstruction”

Journal of Vascular Surgery ◽

10.1016/j.jvs.2007.04.065 ◽

2007 ◽

Vol 46 (3) ◽

pp. 613 ◽

Cited By ~ 1

Author(s):

George S. Georgiadis

Keyword(s):

Femoral Artery ◽

Iliac Artery ◽

Internal Iliac Artery ◽

Drug Addicts ◽

Arterial Reconstruction ◽

Artery Pseudoaneurysm ◽

Beneficial Use ◽

Internal Iliac

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VARIATIONS IN THE BRANCHING PATTERN OF THE INTERNAL ILIAC ARTERY IN AN ADULT MALE – A CASE REPORT. Variaciones en el patrón de ramificación de la arteria ilíaca interna en un varón adulto: informe de un caso

Revista Argentina de Anatomía Clínica ◽

10.31051/1852.8023.v4.n1.13968 ◽

2016 ◽

Vol 4 (1) ◽

pp. 25-28

Author(s):

Satheesha Nayak B ◽

Srinivasa Rao Sirasanagandla ◽

Narendra Pamidi ◽

Raghu Jetti

Keyword(s):

Iliac Artery ◽

Internal Iliac Artery ◽

Clinical Importance ◽

Branching Pattern ◽

Obturator Artery ◽

Cadaveric Specimen ◽

Internal Iliac ◽

Posterior Division ◽

Anterior Division ◽

The Right

Variaciones en el patrón de ramificación de la arteria ilíaca interna son ocasionalmente encontradas en las disecciones cadavéricas y las cirugías. Algunas de las variaciones son de importancia quirúrgica y clínica e ignorarlas podría derivar en alarmantes sangrados durante las prácticas quirúrgicas. Evaluamos las variantes en el patrón de la arteria ilíaca interna en un cadáver masculino. La división de la arteria ilíaca interna dio origen a las arterias rectal media y obturatriz. La arteria vesical superior tenía su origen en la arteria obturatriz. La división posterior de la arteria ilíaca interna dio lugar a las arterias iliolumbar, sacra lateral, glútea superior y pudenda interna. La arteria glútea inferior estaba ausente. Variations in the branching pattern of the internal iliac artery are occasionally encountered during cadaveric dissections and surgeries. Some of the variations are of surgical and clinical importance and ignoring them might result in alarming bleeding during surgical procedures. We report variant branching pattern of the right internal iliac artery in a male cadaveric specimen. The anterior division of the internal iliac artery gave origin to obturator and middle rectal arteries. Superior vesical artery took its origin from the obturator artery. The posterior division of the internal iliac artery gave iliolumbar, lateral sacral, superior gluteal and internal pudendal arteries. The inferior gluteal artery was absent.

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