scholarly journals INTERNAL ILIAC ARTERY CLASSIFICATION AND ITS CLINICAL SIGNIFICANCE. Clasificación de la arteria ilíaca interna y su significación clínica

2016 ◽  
Vol 6 (2) ◽  
pp. 63-71 ◽  
Author(s):  
Waseem Al Talalwah

En estudios anteriores de la arteria ilíaca interna se la ha clasificado en cinco tipos; sin embargo en base a una revisión de estos estudios parece que no hay una clasificación asociada en coexistencia con una arteria ciática. En este estudio, basado en la disección de 171 cadáveres (92 hombres y 79 mujeres), en 65 especímenes del tipo de la arteria ilíaca interna no podía ser clasificada debido a la presencia de una arteria ciática o ausencia de la arteria glútea inferior. Por lo tanto, se propone un sistema de clasificación modificado, ya que es esencial para los radiólogos, cirujanos ortopédicos, obstetras, ginecólogos y urólogos, para ser capaces de reconocer la organización de las principales ramas de las ramas ilíacas internas y evitar el trauma iatrogénico y las complicaciones postquirúrgicas, así como mejorar el manejo del paciente. In previous studies the internal iliac artery has been classified into five types; however based on a review of these studies it does not appear a classification associated with the coexistence of the sciatic artery. In this study, based on 171 dissected cadavers (92 male, 79 female), in 65 specimens the type of internal iliac artery could not be classified due to the presence of a sciatic artery or absence of the inferior gluteal artery. A modified classification system is therefore proposed as it is essential for radiologists, orthopedics, surgeons, obstetricians, gynecologists and urologists to be able to recognize the organization of the major branches of the internal iliac branches to avoid iatrogenic trauma and postsurgical complications, as well as to improve patient management.

2014 ◽  
Vol 2014 ◽  
pp. 1-5
Author(s):  
Waseem Al Talalwah ◽  
Shorok Ali Al Dorazi ◽  
Roger Soames

The lateral sacral artery usually originates from the posterior trunk of the internal iliac artery. The current study of 342 specimens from 171 cadavers (79 male, 92 female) investigated the origin and course of the lateral sacral artery. It was observed to arise from the posterior trunk in 79.1%. Occasionally it originated from the anterior trunk that occurred in 1%. It arose from the sciatic artery in 8.8%, from the superior gluteal artery in 16.8%, and from the inferior gluteal artery in 5.4%. Conversely, the lateral sacral artery is congenital absence in 0.3%. In addition, the lateral sacral artery was single, double, triple, and quadruple in 77.2%, 19.8%, 2.3%, and 0.3%, respectively. Consequently, variability of the lateral sacral artery origin is due to vascular demand as the lateral sacral artery plexus does arise from the earlier trunk development. With variability of the lateral sacral artery origin, there is a variability of the sciatic nerve supply. Knowing the variability of origins, surgeons have to avoid prolonged ligation of the internal iliac artery or its posterior trunk during surgical procedures which may lead to sciatic neuropathy. Therefore, the lateral sacral artery origin, course, and branches are important for clinicians to improve their knowledge and patient management.


2019 ◽  
Vol 2019 (4) ◽  
Author(s):  
Konstantinos Tigkiropoulos ◽  
Ioannis Lazaridis ◽  
Kyriakos Stavridis ◽  
Marianthi Tympanidou ◽  
Dimitrios Karamanos ◽  
...  

2016 ◽  
Vol 2 (3) ◽  
pp. 100-105 ◽  
Author(s):  
Sumathilatha Sakthivelavan ◽  
Sakthivelavan D Sendiladibban ◽  
Christilda Felicia

Objetivo: Estudiar el patrón de ramificación de la arteria ilíaca interna del feto y que son equivalentes a la disposición de las ramas ilíacas internas en los adultos. Métodos: Veinticuatro mitades de pelvis fueron utilizados como muestras. Que se obtuvieron de fetos nacidos muertos, de 5 a 9 meses de edad gestacional. Resultados: la arteria ilíaca interna está en consonancia con la arteria ilíaca común y más grande que la arteria ilíaca externa. Tres tipos de ramificación se observaron sobre la base de las grandes ramas, a saber, la arteria glútea inferior, la arteria pudenda interna y la arteria glútea superior. Los resultados se correlacionaron con los patrones de ramificación descriptos por Piersol (1930). Conclusión: La disposición más común, tenía dos grandes troncos procedentes de la arteria iliaca interna, la posterior era la arteria glútea superior y la anterior se dividía en arterias pudenda y glútea inferior. Los otros patrones conducen variables en los adultos que son de importancia embriológicos y quirúrgicos. Objective: To study the branching pattern of fetal internal iliac artery and to correlate with the arrangement of the internal iliac branches in adults. Methods: Twenty four pelvic halves were used as specimens. They were obtained from the dead born fetuses of 5 to 9 months of gestational age. Results: Internal iliac artery was in line with the common iliac artery and larger than the external iliac artery.  Three types of branching were observed based on the large branches namely inferior gluteal artery, internal pudendal artery and superior gluteal artery. The findings were correlated with the patterns of branching described by Piersol (1930). Conclusion: The most common arrangement had two large trunks originating from internal iliac artery, the posterior one being superior gluteal artery and the anterior one divided into internal pudendal and inferior gluteal arteries. The other patterns lead to variable branching patterns in adults that are of embryological and surgical significance. 


Author(s):  
Wen-qi Yang ◽  
Xiao-lan Cui ◽  
Ming Zhang ◽  
Xiao-dong Yuan ◽  
Liang Ying ◽  
...  

OBJECTIVE: To assess iliac blood vessels using conventional ultrasound (US) and contrast-enhanced ultrasonography (CEUS) before kidney transplantation (KT) and determine whether US findings related to post-transplant outcomes. METHODS: A total of 119 patients received US and CEUS before KT waiting-list acceptance. The preoperative iliac blood hemodynamics and vascular conditions were evaluated. The operative strategy and follow-up outcomes were recorded. Logistic regression and correlation analysis were used. The accuracy in determining the patency of iliac blood vessels was calculated before and after the injection of contrast materials. RESULTS: CEUS can help to significantly improve the visualization of the internal iliac artery, but there was no significant correlation with post-transplant outcomes. In terms of accuracy, there were significant differences in determining the patency of internal iliac arteries between conventional US and CEUS (60.5% and 100%, p <  0.001). The surgical strategy of one patient was regulated and two patients were excluded from KT according to US findings. CONCLUSIONS: Compared with conventional US, CEUS helps to improve the visualization of the internal iliac artery. Conventional US and CEUS have the potential to serve as effective methods to evaluate anatomy and hemodynamics of iliac vessels and have a potential value while defining clinical algorithms in surgery decision-making.


2020 ◽  
pp. 153857442098181
Author(s):  
Paolo Perini ◽  
Erica Mariani ◽  
Mara Fanelli ◽  
Alessandro Ucci ◽  
Giulia Rossi ◽  
...  

Objectives: The purpose of this paper is to report the different modalities for the treatment of isolated internal iliac artery aneurysms (IIIAA), as well as their outcomes. Methods: We performed a systematic review of the literature (database searched: PubMed, Web of Science, Scopus, Cochrane Library; last search: April 2020). We included articles reporting on the outcomes for IIIAA interventions comprising at least 5 patients. Studies were included when presenting extractable outcome data regarding intraoperative and/or early results. We performed meta-analyses of proportions for different outcomes, using random effects model. Results: Thirteen non-randomized studies were included (192 patients with 202 IIIAA). IIIAA were symptomatic in the 18.1% (95%CI 9.3-26.9; I2 54.46%, P = .019). Estimated mean IIIAA diameter was 46.28 mm (95%CI 39.72-52.85; I2 88.85%, P < .001). Open repair was performed in 21/202 cases. Endovascular treatments were: embolization (81/181), embolization and hypogastric artery coverage (79/181), hypogastric artery coverage by stent-grafting (15/181), stent-grafting in the hypogastric artery (6/181). Overall estimated technical success (TS) rate was 91.6% (95% CI 86.8-95.5; I2 45.82%, P = .031). TS rate was 94.5% for open surgery (95%CI 85.3-100; I2 0%, P = .907), and 89.7% for endovascular repair (95%CI 83.8-95.6; I2 55.43%, P = .006). Estimated overall 30-day mortality was 3.1% (95%CI 0.8-5.4; I2 0%, P = .969). Mortality rates after open surgery and endovascular repair were 8.2% (95%CI 3.4-19.8; I2 0%, P = .545) and 2.8% (95%CI 0.5-5.1; I2 0%, P = .994), respectively. Estimated mean follow-up was 32.63 months (95%CI 21.74-43.53; I2 94.45%, P < .001). During this timeframe, IIIAA exclusion was preserved in 92.8% of the patients (95%CI 89.3-96.2; I2 0%, P = .797). Buttock claudication occurred in 13.9% of the patients (95%CI 8.7-19.2; I2 0%, P = .622). Conclusions: IIIAA are frequently large, and symptomatic at presentation. Several treatments are proposed in literature, open and endovascular, both with good results. The endovascular treatment is the preferred method of treatment in literature, since it offers good short- to mid-term results and low early mortality. Buttock claudication after hypogastric artery exclusion is a common complication.


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