Anatomical variations of the anterior division of the internal iliac artery in Thiel embalmed cadavers (a practical study).

Abstract

Abstract The internal iliac artery (IIA) is the main arterial supply to the pelvis and its organs. The arterial tree has many anatomical variations. These variations are clinically significant in pelvic related procedures such as arterial ligation and embolization. Aim: To investigate the various branching patterns of the anterior division of the IIA using Thiel embalmed cadavers and record the presence of variations in this Scottish population. Materials and methods: A cadaveric dissection was carried out on 22 cadavers (44 pelvic halves, 13 males and 9 females). Then, the length of the IIA and anterior division were measured and the branching patterns were recorded and photographed. Results: The internal iliac artery and its branches showed many anatomical variations in their branching patterns. The IIA length had an average length of 48.27±4 mm and the anterior division was 12.81±1.8mm. In 90% (40/44) the IIA divided into anterior and posterior trunks. The anterior division gave origin to many branches including the umbilical (UA), superior vesical (SVA), obturator (OA), inferior vesical (IVA), middle rectal (MRA), internal pudendal (IPA), and inferior gluteal (IGA) arteries. In females, the vaginal (VA) and uterine (UtA) arteries replace the IVA. The UA, SVA, UtA, VA and IPA were found to be constant anterior division branches or less commonly direct branches from the IIA (10%). The IVA, MRA and IGA originated from different sites within the internal iliac system. The OA had a wide variety of origins from the internal iliac and external iliac systems. The textbook arterial pattern was reported in only 17 sides out of 44 (38.6 %) of individuals dissected; 7 (4 right, 3 left) female sides and 10 (4 right,6 left) male sides. Conclusion: The IIA and its branches anatomy are important in performing pelvic related procedures and operations especially in arterial ligation and embolization. A wide range of variation was found in the Scottish population. Therefore, in carrying out any procedures a careful planning, in addition to knowledge of the typical and possible variations of each artery is fundamental.