Pelvis
Harold Ellis, Adrian Kendal Dixon, Bari M. Logan, David J. Bowden in Human Sectional Anatomy, 2017
In image C, the confluence of the two common iliac veins forming the inferior vena cava (29) can be appreciated. So too can the continuation of the aorta (28) as the left common iliac artery; the right common iliac artery cannot be seen on this image, as it lies in a more anterior position as it passes anterior to the confluence of the common iliac veins. This is an important point, as the veins usually lie posterior to the arteries in this region – this is also true for the external iliac and popliteal vessels. More superiorly in the body (brachiocephalic, pulmonary and renal), the veins lie anterior to the arteries.
Test Paper 2
Teck Yew Chin, Susan Cheng Shelmerdine, Akash Ganguly, Chinedum Anosike in Get Through, 2017
Study results suggest higher complications for aneurysms larger than 5.5–6.5 cm. The shape can be described as saccular or fusiform. The residual lumen through the aneurysm should measure approximately 18 mm to allow passage and proper deployment of the device. The preferred distal landing zone is the common iliac artery. Evaluation is similar to that of the proximal neck with assessment of diameter, length, tortuosity and degree of calcification and thrombus. The common iliac artery diameter should not be larger than 25 mm, and at least 10 mm of length is required for an adequate seal.
Complex lower extremity revascularization
Peter A. Schneider in Endovascular Skills: Guidewire and Catheter Skills for Endovascular Surgery, 2019
When assessing iliac artery occlusions, it makes a difference as to whether these lesions are located in the common iliac artery alone or the external iliac artery alone, or whether they involve both the common and the external iliac arteries. In general, results are better with common iliac artery occlusions than with external iliac artery occlusions. The common iliac artery is a larger, shorter artery. Results with either common or external iliac artery occlusions are better than those in which both arteries are occluded on the same side. This is true for technical success and for long-term patency. A patent internal iliac artery is helpful in recanalizing either a common iliac artery or an external iliac artery occlusion. The occlusion usually ends at the origin of the internal iliac artery. The internal iliac artery maintains flow in the patent segment juxtaposed to the occlusion. It can be used to anchor a wire. It can also be used to assist the operator in directing the wire in the correct direction to get across an iliac occlusion. With respect to common or external iliac artery occlusions, if the proximal end or the distal end of the artery at the lesion has a beak of patent vessel leading into the occlusion (as opposed to a flush occlusion), this will enhance getting into the occlusion (Figure 25.2). In the case of a common iliac artery occlusion, the beak or stump can be used to enter the occlusion, either by coming in proximally from the brachial artery or by coming in over the aortic bifurcation from the contralateral side. If there is a flush occlusion of the proximal end of a common iliac artery occlusion, the benefit of approaching the lesion from a proximal access is higher. This is because the up-and-over approach is disadvantaged when approaching a flush occlusion.
A fatal and unusual iatrogenic fourth right lumbar artery injury complicating wrong-level hemilaminectomy: a case report and literature review
Published in British Journal of Neurosurgery, 2019
Francesco Ventura, Rosario Barranco, Carlo Bernabei, Lara Castelletti, Lucio Castellan
Vascular damage is most commonly related to L4-L5 and L5-S1 level laminectomy.12–14 Within these levels, the inferior vena cava is interposed between the disc and the right or common iliac arteries.12 The left common iliac artery is susceptible to injury due to its medial course and intimate relationship with the L4-L5 intervertebral disc. The aorta and inferior vena cava are subject to surgical injury at the level comprised within the second and fourth lumbar vertebrae, whereas the distal segments of the iliac vessels are exposed to any injury at the level of the fourth lumbar vertebra.15 Finally, the internal iliac veins, lumbar arteries, inferior mesenteric artery, median sacral artery and the superior rectal artery are other vessels that may also be injured during lumbar disc surgery.5,16
Aortic thrombosis in a neonate with COVID-19-related fetal inflammatory response syndrome requiring amputation of the leg: a case report
Published in Paediatrics and International Child Health, 2021
Priyanka S. Amonkar, Jeetendra B. Gavhane, Suhas N. Kharche, Sameer S. Kadam, Dattatray B. Bhusare
As the gangrene of the right limb progressed, embolectomy was undertaken on Day 12 of hospitalisation. A 1-cm clot was retrieved from the distal aorta and a small clot was removed from the right common iliac artery. Post-embolectomy Doppler demonstrated flow in the common femoral, deep femoral and popliteal arteries bilaterally, and the aorta showed no evidence of thrombus. Unfortunately, on Day 16, amputation of the right limb below the knee was required, and low molecular weight heparin and aspirin were commenced. Oral corticosteroids were continued, and inflammatory markers showed serial return to normal by Day 21 (Day 31 of life) (Table 1). The neonate was discharged on Day 28 with aspirin for 6 weeks and a plan to taper corticosteroids over the following 4 weeks. At 1-month follow-up, he was doing well with adequate weight gain and good healing of the wound, and there were no amputation stump-related complications.
Retroperitoneal liposarcoma in older person – a rare case report
Published in The Aging Male, 2020
Navas Nadukkandiyil, Sameer Valappil, Marwan Ramadan, Essa Al Sulaiti, Hanadi Khamis Alhamad
We report here a case of primary dedifferentiated liposarcoma in the retroperitoneum. A 77-year-old elderly gentleman was presented to our outpatient clinic with chief complaints of urinary incontinence for the last four years, weight loss >10 kg since 1 year, loss of appetite, tiredness and chronic constipation. On examination he had a mass in the right iliac fossa, measuring around 8 cm × 5 cm, hard in consistency, immobile and non-pulsatile on evaluation. He had microcytic hypochromic anemia and renal impairment with negative stool occult blood with all other basic investigation normal. Abdominal ultrasonography showed Ill-defined solid mass like area with vascularity are right lower quadrant measuring 11.4 × 11.5 cm. We proceeded with CT abdomen with contrast, which showed a large lower abdominal and pelvic retroperitoneal mass lesion occupying the midline and right lower abdomen measuring approximately 13 × 15 × 12.5 cm. The mass demonstrates inhomogeneous enhancement with a few small areas of necrosis. No calcification or definite fat component identified. The mass was encasing the right common iliac, external and internal iliac vessels with marked narrowing of the right common iliac and proximal external iliac vein. A short segment of a partially thrombosed right common iliac artery noted with atheromatous aortic calcification. Right pelvic ureter was displaced anteriorly and is markedly compressed at the level of the lesion with upstream moderate hydroureteronephrosis.