Posterior division of the internal iliac artery: Anatomic variations and clinical applications.
OBJECTIVE
The objective of the study was to characterize the anatomy of the internal iliac artery (IIA) and its posterior division branches and to correlate these findings to IIA ligation.


METHODS
Dissections were performed in 54 female cadavers.


RESULTS
Average length of IIA was 27.0 (range, 0-52) mm. Posterior division arteries arose from a common trunk in 62.3% (66 of 106) of pelvic halves. In the remaining specimens, branches arose independently from the IIA, with the iliolumbar noted as the first branch in 28.3%, lateral sacral in 5.7%, and superior gluteal in 3.8%. The average width of the first branch was 5.0 (range, 2-12) mm. In all dissections, posterior division branches arose from the dorsal and lateral aspect of IIA. The internal iliac vein was lateral to the artery in 70.6% (12 of 17) of specimens on the left and 93.3% (14 of 15) on the right.


CONCLUSIONS
Ligation of the IIA 5 cm distal from the common iliac bifurcation would spare posterior division branches in the vast majority of cases. Understanding IIA anatomy is essential to minimize intra-operative blood loss and other complications.
Division of Urogynecology and Reconstructive Surgery, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
April T
AT
Bleich
David D
DD
Rahn
Cecilia K
CK
Wieslander
Clifford Y
CY
Wai
Shayzreen M
SM
Roshanravan
Marlene M
MM
Corton
D000368:Aged; D000369:Aged, 80 and over; D002102:Cadaver; D004210:Dissection; D005260:Female; D006801:Humans; D007083:Iliac Artery / Q000033:anatomy & histology* / Q000601:surgery; D008026:Ligation; D008875:Middle Aged