THE COLLATERAL ARTERIAL CIRCULATION IN THE PELVIS

AN ANGIOGRAPHIC STUDY

¹ From the Departments of Radiology, Obstetrics, and Gynecology, State University of New York, Downstate Medical Center and the Kings County Hospital Center, Brooklyn, New York

Nineteen patients ranging in age from 9 to 49 years were subjected to pelvic angiography following internal or common iliac artery occlusion. None of those patients manifested evidence of cardiovascular disease.

Roentgenographic demonstration of the major arterial anastomoses is presented. The anastomoses shown are:

1. Last lumbariliolumbar

2. Lateral sacrallateral sacral

3. Middle sacrallateral sacral

4. Superior hemorrhoidalmiddle hemorrhoidal

5. Medial femoral circumflexinferior gluteal

6. Medial femoral circumflexobturator

7. Lateral femoral circumflexsuperior gluteal

8. Deep iliac circumflexsuperior gluteal

9. Deep iliac circumflexexternal iliac

10. Last lumbarsuperior gluteal

11. Last lumbardeep iliac circumflex

12. Iliolumbardeep iliac circumflex.

These anastomoses have been shown to function immediately following occlusion.

Attempts at reduction of blood flow to pelvic structures may be successful, although complete cessation of perfusion probably cannot be accomplished.

Occlusion of the external iliac artery due to trauma to the intima or to spasm may be an unrecognized complication of catheter angiography, since peripheral flow and pulse may be maintained.

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