Sumathilatha, S (2007) A Study on the Branches and the Branching pattern of Internal Iliac Artery including its Surgical and Radiological implications. Masters thesis, Madras Medical College, Chennai.
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Abstract
Internal iliac artery, the vessel of surgical and radiological significance, has been studied in detail by dissection and radiological methods. The length of the artery, its extent, its relation with the adjacent important structures, its branches and branching pattern and obturator artery in detail have been observed and correlated with the findings of already existing studies. The following conclusions are derived from these parameters: The mean length of internal iliac artery is 3.7cm. The minimum length is 2.3cm and the maximum length is 7.1cm. Internal iliac artery originates in most of the cases at the level of lumbosacral articulation. In majority of specimens, internal iliac artery bifurcates at the level of upper border of greater sciatic notch. Internal iliac artery is related to ureter anteriorly and internal iliac vein posteriorly. Common iliac vein and external iliac vein are posterolateral to the artery. The most common mode of termination of internal iliac artery is by dividing into anterior and posterior divisions. In most of the specimens one or two branches arise from the main stem of internal iliac artery even before its bifurcation. However, in a significant proportion it is found to give rise to larger terminal branches without dividing into two trunks. The anterior division gives rise to inferior gluteal artery, internal pudendal artery, obturator artery, superior vesical artery, inferior vesical artery, middle rectal artery, and uterine and vaginal artery in females. However inferior gluteal artery, obturator artery and middle rectal artery are noted to arise from posterior division in a few instances. The posterior division gives origin to lateral sacral artery, iliolumbar artery and superior gluteal artery, of which lateral sacral artery is noted to originate from anterior division in a few specimens. Bilateral and unilateral abnormal obturator artery is found to arise from external iliac artery or its branch namely inferior epigastric artery in significant proportion of cases. Origin of abnormal obturator artery by two roots, from both internal iliac artery and external iliac artery is also noted. Abnormal obturator artery is related in most of the cases to the lateral border of femoral ring. The highest proportion of cases display the branching patterns namely Type I of Adachi’s classification and Type V of Anson’s classification. Among the twelve fetal specimens studied internal iliac artery is in line with the common iliac artery in contrast to that of adults where external iliac artery is in line with common iliac artery. The branches and branching pattern of foetal internal iliac artery are studied and inferior gluteal artery and obturator artery noted to originate from posterior trunk in a few cases. In a significant proportion there was no clear cut division into anterior and posterior trunks. Under radiological study, the anatomical knowledge is further extended to identify and precisely locate the various branches of internal iliac artery, which are of importance in the angiographic procedures. Based on this study, I hereby conclude that the “arterial tree” of internal iliac artery is composed of complex variations in the length, extent and its branches. Starting from surgery for femoral hernia to the latest procedures of interventional radiography, require a thorough knowledge of variations in internal iliac artery and its branches. Hence I hope that this study would be of great use to surgeons and radiologists.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Internal Iliac Artery; Branching pattern; Surgical and Radiological implications. |
| Subjects: | MEDICAL > Anatomy |
| Depositing User: | Kambaraman B |
| Date Deposited: | 22 Jun 2017 05:43 |
| Last Modified: | 22 Jun 2017 06:32 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/219 |
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