THE COLLATERAL ARTERIAL CIRCULATION IN THE PELVIS

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Abstract
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 lumbar→iliolumbar 2. Lateral sacral↔lateral sacral 3. Middle sacral→lateral sacral 4. Superior hemorrhoidal→middle hemorrhoidal 5. Medial femoral circumflex→inferior gluteal 6. Medial femoral circumflex↔obturator 7. Lateral femoral circumflex→superior gluteal 8. Deep iliac circumflex→superior gluteal 9. Deep iliac circumflex→external iliac 10. Last lumbar→superior gluteal 11. Last lumbar→deep iliac circumflex 12. Iliolumbar→deep 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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