Novel, congenital iliac arterial anatomy: Absent common iliac arteries and left internal iliac artery

Background: Massive pelvic haemorrhage is a potentially lethal complication while undergoing obstetric and gynaecological surgery. The objective of this study was to study of role of bilateral internal iliac artery ligation in severe obstetric and gynaecological haemorrhage. It was a prospective interventional study carried out in a multi-speciality tertiary care hospital in New Delhi.Methods: Thirty-five patients (31 obstetric and 4 gynaecological) fulfilling the inclusion criteria over a period of 2 years were included in the study cohort after informed consent. After laparotomy, internal iliac arteries were exposed by incising the peritoneal fold between the infundibulo-pelvic and round ligaments. A number 1 silk suture and right-angled artery forceps were used to tie the internal iliac arteries approximately 1 inch below their origin. The success and complications of the procedure were analysed.Results: In the present study 31 out of 35 cases underwent BIIAL for obstetrical cause of haemorrhage and rest 4 for gynaecological cause. In 19 out of 31 patients, hysterectomy preceded or followed BILAL depending upon the clinical situation making a uterine salvation rate of 38.7%. The success rate of BIIAL was 67.7% in 31 obstetric cases. In the 4 gynaecological cases BILAL was done to arrest post-hysterectomy haemorrhage and success rate was 100%. Among 35 patients one patient died of haemorrhagic shock and 4 other died of full blown sepsis and MODS in surgical ICU. No significant procedure related complications were encountered.Conclusions: BILAL is a very effective procedure to control PPH and pelvic haemorrhage due to other causes and helps save the much precious lives and uteri. This procedure can always be tried where procedures like embolization are unavailable.

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Morphological considerations on the origin and morphometry of the internal iliac arteries

ARS Medica Tomitana ◽

10.1515/arsm-2015-0010 ◽

2014 ◽

Vol 20 (4) ◽

pp. 219-227

Author(s):

Oana Popa ◽

P. Bordei ◽

D. Iliescu ◽

C. Ionescu

Keyword(s):

Intervertebral Disc ◽

Iliac Artery ◽

Internal Iliac Artery ◽

Single Case ◽

Front Face ◽

Iliac Arteries ◽

Internal Iliac ◽

The Right ◽

Different Levels ◽

Internal Iliac Arteries

Abstract The origin of the internal iliac artery, right and left, was studied in 76 cases, 58 cases of male (76.32% of all cases) and 18 female cases (23.68% of all cases). The origin of the internal iliac arteries was considered in relation to the spine (lumbar-sacral). The right internal iliac artery males originates in a range from the upper edge of L4 vertebra - the lower part of fin sacral. It is found that in males, in most cases, 43 cases (74.14% of male cases), right internal iliac artery originates at different levels of sacral fin. We considered that the right iliac artery low origin only the cases in the lower part of the fin sacral, 10 cases (17.24% of male cases). Cases of high origin of the artery, above the fin sacral we found it in 15 cases (25.86% of male cases). From high origins, in the upper edge of the L4 vertebra and intervertebral disc at L4-L5, I met only one single case. Right internal iliac artery in females originated in a range between the upper edges of L5 - the lower part of sacral fin. In females, the right internal iliac artery origin, is located within narrower than in men, but in women, most frequently, 14 cases (77.78% of female the cases) was the origin of the internal iliac located at different levels of sacral fin. The females have not met internal iliac origin above the L5 vertebra or intervertebral disc level L4-L5. High origin was met it in 4 cases (22.22% of female the cases) and low origin in 6 cases (33.33% of female the cases). The level of the left internal iliac artery origin we studied 78 cases, finding it in the same range as in males, i.e., the upper edge of L4 vertebra - the front of the sacrum. In males, on a number of 57 cases (73.08% of all cases) the origin of the left internal iliac artery was made between the upper edge of the vertebra L4 - the front face of the sacrum, most commonly, in 44 cases (77 19% of male the cases) located in the sacral fin. The artery high origin I found it in 9 cases (15.79% of male the cases) and low origin in 18 cases (31.58% of male the cases). I have not met artery origin at L5-S1 intervertebral disc. In terms of low origin, only in males, the left internal iliac artery originated from the anterior to the sacrum, something not found the right internal iliac artery. In females, the 18 cases followed, had their origins in the range lower half of the L5 - middle sacral fin, 17 cases (94.44% of female the cases), terminating at the sacral fin. It is found that in women the origin of the left internal iliac artery is within narrower than the other cases described so far, showing the highest level of origin, this artery in females do not possess low origin. The high origin is present in a small percentage, only 5.56% of cases, encountering any case the origin of the left internal iliac artery is located at the L4 vertebra or the intervertebral discs at L4-L5 or L5-S1. Internal iliac artery diameter was followed on 90 cases, 44 cases for the right internal iliac artery and 46 cases for left internal iliac artery. In males, the right internal iliac artery I found a caliber between 3 to 9.8 mm. In women the right internal iliac artery caliber found between 3.9 to 6.9 mm.

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Two cases of buttock claudication caused by isolated internal iliac artery stenosis

VASA ◽

10.1024/0301-1526.35.3.209 ◽

2006 ◽

Vol 35 (3) ◽

pp. 209-211 ◽

Cited By ~ 4

Author(s):

Kahle ◽

Schmidt-Lucke

Keyword(s):

Iliac Artery ◽

Internal Iliac Artery ◽

Transluminal Angioplasty ◽

Artery Stenosis ◽

Adequate Treatment ◽

Iliac Arteries ◽

Iliac Artery Stenosis ◽

Buttock Claudication ◽

Internal Iliac ◽

Percutaneous Transluminal

We present two cases of buttock claudication caused by severe stenosis of the internal iliac artery which disappeared totally after percutaneous transluminal angioplasty (PTA). Isolated stenoses of internal iliac arteries are rare. It is often difficult to distinguish between vascular buttock claudication and neurological or orthopaedic symptoms. Conventional or MR-angiography is necessary to secure the diagnosis. PTA of internal iliac artery stenosis is the adequate treatment.

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Novel Endovascular Approach Using the Gore Iliac Branch Endograft for Short Iliac Anatomy

Journal of Endovascular Therapy ◽

10.1177/1526602817746127 ◽

2017 ◽

Vol 25 (1) ◽

pp. 28-30 ◽

Cited By ~ 3

Author(s):

Kejia Wang ◽

Laura Dunkley ◽

Michael Neale

Keyword(s):

Aortic Aneurysm ◽

Internal Iliac Artery ◽

Iliac Arteries ◽

Infrarenal Aortic Aneurysm ◽

Landing Zone ◽

Internal Iliac ◽

Endovascular Approach ◽

The Right ◽

Common Iliac Arteries

Purpose: To report the use of a branched iliac endograft to maintain internal iliac artery (IIA) patency in a patient with an infrarenal aortic aneurysm and short common iliac arteries (CIA). Case Report: A 74-year-old man presented with an asymptomatic, fusiform, 67-mm infrarenal aortic aneurysm confirmed on computed tomography. The right CIA was funnel shaped and only 15 mm in length, providing no appropriate stent-graft landing zone. The left CIA measured 14 mm in diameter and 25 mm in length. Endovascular repair of the aneurysm with preservation of the IIAs was achieved using a Gore Iliac Branch Endoprosthesis for the short right CIA and a conventional limb to land in the left CIA. Follow-up scans to 24 months have shown continued patency of the IIA and no evidence of endoleak. Conclusion: The Gore Iliac Branch Endograft can be used to successfully treat patients with short CIA anatomy while preserving flow to the ipsilateral IIA, with maintained early patency of the IIA limb.

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Rare origin of the obturator artery from the external iliac artery with two obturator veins

Jornal Vascular Brasileiro ◽

10.1590/1677-5449.005116 ◽

2016 ◽

Vol 15 (3) ◽

pp. 250-253 ◽

Cited By ~ 2

Author(s):

Kiyoshi Goke ◽

Lucas Alves Sarmento Pires ◽

Tulio Fabiano de Oliveira Leite ◽

Carlos Alberto Araujo Chagas

Keyword(s):

Iliac Artery ◽

Internal Iliac Artery ◽

External Iliac Artery ◽

Lateral Wall ◽

Iliac Vein ◽

Obturator Foramen ◽

Obturator Artery ◽

Iliac Arteries ◽

Internal Iliac ◽

The Common

Abstract The obturator artery is a branch of the internal iliac artery, although there are reports documenting variations, with origin from neighboring vessels such as the common iliac and external iliac arteries or from any branch of the internal iliac artery. It normally runs anteroinferiorly along the lateral wall of the pelvis to the upper part of the obturator foramen where it exits the pelvis by passing through said foramen. Along its course, the artery is accompanied by the obturator nerve and one obturator vein. It supplies the muscles of the medial compartment of the thigh and anastomoses with branches of the femoral artery on the hip joint. We report a rare arterial variation in a Brazilian cadaver in which the obturator artery arose from the external iliac artery, passing beyond the external iliac vein toward the obturator foramen, and was accompanied by two obturator veins with distinct paths. We also discuss its clinical significance.

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Iliac Artery Aneurysms

10.2310/vasc.3018 ◽

2017 ◽

Author(s):

Amani D Politano ◽

Kenneth J. Cherry

Keyword(s):

Iliac Artery ◽

Open Repair ◽

Internal Iliac Artery ◽

Common Iliac Artery ◽

Artery Aneurysm ◽

Iliac Artery Aneurysm ◽

Iliac Arteries ◽

Internal Iliac ◽

The Common ◽

Repair Techniques

The terminal abdominal aorta divides into the common iliac arteries at the L4 level. At the level of the sacrum, the common iliac arteries divide into the external iliac arteries and internal iliac (hypogastric) arteries. This review covers aneurysms of the iliac arteries, with discussion of the anatomy, clinical evaluation, investigative studies, management, and follow-up imaging. Figures show common presenting configurations of iliac artery aneurysms, examples of open repair techniques for common iliac artery aneurysms, example of internal iliac artery revascularization in the setting of common iliac artery aneurysm repair, examples of endovascular repair techniques for common iliac artery aneurysms, complex hybrid repair of multiple iliac aneurysms, examples of open repair techniques for internal iliac artery aneurysms, and examples of endovascular repair for internal iliac artery aneurysms. Tables list normal diameters reported by the Subcommittee on Reporting Standards for Arterial Aneurysms, rate of growth of aneurysms based on size at presentation, presenting signs and symptoms of iliac artery aneurysm, and location, rupture, and mortality reported in the literature. This review contains 7 highly rendered figures, 4 tables, and 91 references Keywords: Iliac artery aneurysms; IAA; Common iliac artery aneurysms; Internal iliac artery aneurysm; IIAA; External iliac artery aneurysm

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Endovascular reconstruction of iliac artery bifurcation atherosclerotic disease with the kissing technique

Vascular ◽

10.1177/1708538113478748 ◽

2013 ◽

Vol 21 (5) ◽

pp. 339-342

Author(s):

Georgios Vourliotakis ◽

Georgios Mantas ◽

Athanasios Katsargyris ◽

Christine Aivatidi ◽

Yannis Kandounakis

Keyword(s):

Lower Extremity ◽

Iliac Artery ◽

Endovascular Repair ◽

Internal Iliac Artery ◽

Balloon Catheter ◽

External Iliac Artery ◽

Atherosclerotic Disease ◽

Iliac Arteries ◽

Left Buttock ◽

Internal Iliac

A 71-year-old male patient with severe left buttock and lower-extremity claudication due to iliac artery bifurcation stenoses was referred to our institution for endovascular treatment. A ‘kissing’ technique was used in order to dilate the proximal parts of both internal and external iliac arteries and avoid compromization of the internal iliac artery during proximal external iliac artery stenting. A balloon expandable stent was inserted via a left ipsilateral retrograde access to the narrowed origin of the left external iliacartery and a balloon catheter via a right contralateral access inside the origin of the left internal iliac artery. Simultaneous balloons inflation restored full patency of both vessels. Twelve months later the patient is doing well, free of buttock or lower-extremity claudication symptoms. For iliac artery bifurcation atherosclerotic disease, endovascular repair with the ‘kissing’ technique can achieve a complete bifurcation reconstruction offering significant clinical benefit in selected patients.

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LONG-TERM RESULTS OF RECONSTRUCTION OF THE INFERIOR MESENTERIC AND INTERNAL ILIAC ARTERIES DURING RESECTION OF THE ANEURYSM OF THE INFRARENAL AORTIC SEGMENT

Grekov s Bulletin of Surgery ◽

10.24884/0042-4625-2018-177-4-67-72 ◽

2018 ◽

Vol 177 (4) ◽

pp. 67-72

Author(s):

A. Ya. Bedrov ◽

A. A. Moiseev ◽

A. V. Belozertseva ◽

A. N. Morozov ◽

Yu. A. Pugachenko

Keyword(s):

Iliac Artery ◽

Mesenteric Artery ◽

Inferior Mesenteric Artery ◽

Internal Iliac Artery ◽

Clinical Manifestations ◽

Long Term Results ◽

Iliac Arteries ◽

Aortic Segment ◽

Internal Iliac ◽

Internal Iliac Arteries

The OBJECTIVE is to assess the patency of the inferior mesenteric artery and internal iliac arteries in the remote period after resection of the aneurysm of the infrarenal aortic segment. MATERIAL AND METHODS. The study included 33 patients who underwent resection of the abdominal aortic aneurysm with reconstruction of the inferior mesenteric artery and (or) internal iliac arteries from 1998 to 2017. All patients were examined with computed tomography scan with contrast to assess the patency of inferior mesenteric artery and internal iliac arteries. RESULTS. Patients were observed from 0.5 to 15 years. Among 30 patients with inferior mesenteric artery implanted into the prosthesis, 23 (76 %) patients had a passable inferior mesenteric artery and 7 patients had an occluded inferior mesenteric artery. The implanted inferior mesenteric artery maintained its patency for 3 years in 100% of cases, from 3 to 5 years – in 86%, after 5 years and more – in 62%. In one patient who underwent reconstruction of the internal iliac artery, thrombosis of the prosthetic-internal iliac shunt was found out in 1.5 years after the operation, without any clinical manifestations. One patient, underwent the reconstruction of the internal iliac artery, was diagnosed with thrombosis of the prosthetic-internal iliac shunt in 1.5 years after the operation, which was not accompanied by clinical manifestations. CONCLUSION. The high remote patency of the inferior mesenteric artery and internal iliac arteries reconstructed during resection of the aneurysm of the infrarenal aortic segment indicates the need for this procedure in order to prevent ischemic disorders of the digestive organs and pelvis.

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