Inferior epigastric artery arising from the obturator artery as a terminal branch of the internal iliac artery and consideration of its rare occurrence

The origins of the inferior epigastric and obturator arteries and the relationship between these arteries have been determined macroscopically in examinations of 706 body-halves of Japanese subjects. Three very rare inferior epigastric arteries were found to arise from the obturator artery leaving the internal iliac artery. The intimate relationship between these arteries has been documented by the obturator artery arising from the inferior epigastric artery and the anastomosis between them. It is generally interpreted that such anomalies occur as remnant or partial disappearance of the connection between the pubic branches of the inferior epigastric and obturator arteries. The inferior epigastric artery arising from the obturator artery is also thought to be a similar anomaly. Since the obturator artery from the inferior epigastric artery represents one form of extreme anomaly, and the inferior epigastric artery from the obturator artery represents another form, it would seem that these two forms of extreme anomaly should occur at similar frequencies. However, in our research, the incidence of the former was 10.5% while that of the latter was a very low 0.4%. During normal development, the inferior epigastric artery is established at an earlier stage than the obturator artery as a channel for blood supply. We suppose that the difference of blood flow resulting from this time lag is one of the reasons why the inferior epigastric artery from the obturator artery is very rare in comparison to the obturator artery from the inferior epigastric artery.     

Arterial supply to the sciatic nerve in the gluteal region

The arterial supply to the sciatic nerve was investigated in 20 human lower limbs (10 right, 10 left) from 20 cadavers (14 females, aged 84 +/- 9.6 years, range 66-95 years: 6 males, aged 80 +/- 8.2 years, range 70-90 years). In all limbs examined at least 1 sciatic artery could be identified supplying the sciatic nerve in the gluteal region. In total 28 sciatic arteries were identified, of which 14 arose from the medial circumflex femoral artery, 11 from the inferior gluteal artery, 2 from the first perforating artery, and 1 from the internal pudendal artery. In 5 limbs, 2 sciatic arteries were observed, being independent branches from the medial circumflex femoral and inferior gluteal arteries in 4 limbs and separate branches of the medial circumflex femoral artery in 1 limb. In 1 limb, 4 sciatic arteries were observed: 1 from the inferior gluteal artery, 2 from the medial circumflex femoral artery, and 1 from the first perforating artery. In the remaining 14 limbs a single sciatic artery was observed, which in one case arose from the internal pudendal artery, a previously unreported observation.     

Deep femoral artery with four variations: a case report

During our routine dissection course for students we found a complex variation of the femoral artery on the left side of a 72-year-old male cadaver. The deep femoral artery was originating from the anterior aspect of the femoral artery; the inferior epigastric and the external pudendal arteries were arising from the deep femoral artery. Besides, the lateral circumflex femoral artery was arising from the lateral aspect of the femoral artery and distal to the origin of the deep femoral artery.     

Rare case of the inferior mesenteric artery and the common hepatic artery arising from the superior mesenteric artery

We found a case in which inferior mesenteric artery and the common hepatic artery arose from the superior mesenteric artery, forming the common hepatomesenteric trunk, during a routine dissection carried out at Iwate Medical University in 2002. This variation is rare, but can be embryonically explained. A change in the positions of the disappearance of the ventral splanchnic arteries and the longitudinal anastomotic channel results in variations in the system of arteries distributed to the digestive organs. In the present case, the longitudinal anastomotic channel between the superior and the inferior mesenteric arteries survived to form the common mesenteric artery, which was joined by the common hepatic artery, forming the common hepatomesenteric trunk.     

异常闭孔动脉的形态特点及其临床意义

目的　观察异常闭孔动脉的走形、分布,并对其盆内段进行测量和定位,为腹股沟区相关手术提供可靠的解剖学基础。 方法　解剖研究37侧成人骨盆标本,对闭孔动脉进行观测和分类,并测量闭孔动脉盆内段长度,起始端外径,闭孔管处外径,以及闭孔动脉入闭孔处和髂前上棘与耻骨联合连线中点的距离。 结果　在37侧标本中,异常闭孔动脉出现率为18.92%。异常闭孔动脉与腹壁下动脉共干（1.57±0.12）cm发出,盆内段平均长度（4.05±0.49）cm,起始处平均外径（2.52±0.87）mm,闭膜管处闭孔动脉平均外径（2.14±0.72）mm,入闭孔处和连线中点的距离（3.63±1.29）cm。异常闭孔动脉多与腹壁下动脉共干,之后绕股环或跨过股环,紧贴盆壁下降至闭孔处。 结论　正是由于异常闭孔动脉的特殊性质,在腹股沟区及骨盆、髋区骨折固定手术,甚至肿瘤治疗、淋巴结清除术中,术者当引起重视。     

Extraneural arterial blood vessels of human fetal sciatic nerve

Nerves get segmental blood supply either from the neighboring muscular and cutaneous branches or from the regional main arterial trunks. The aim of our research was to detect, in the gluteal and posterior femoral region, the blood vessels which are involved in the blood supply of the human fetal sciatic nerve, as well as to establish their origin. Micro-dissection was performed on 48 fetal lower extremities which were previously fixed in 10% formalin. Micropaque solution (barium sulfate) was injected into their blood vessels. The fetal gestational age was established by measuring the crump-crown length and it ranged from the third to the ninth lunar month. The observed nutritional arteries of the human sciatic nerve originated from the inferior gluteal artery, medial circumflex femoral artery, perforating branches, and popliteal artery. The anastomotic arterial chain of the human sciatic nerve was observed in all cases. In 75% of the cases it was composed of the branches of the inferior gluteal artery, the medial circumflex femoral artery and the first two perforating arteries. The nutrient branch of the third perforating branch was less frequently (in 14.5% of the cases) part of this anastomotic arterial chain.     

Single coronary artery arising from the right sinus of Valsalva (case report)

A single coronary artery is a rare congenital anomaly of the coronary arteries where only one coronary artery arises from the aortic trunk by a single coronary ostium, supplying the entire heart. We report a case of a 70 years-old man with mitral valvular insufficiency and atherosclerotic right and left circumflex coronary arteries, in whom coronary angiography showed a single coronary artery arising from a single ostium in the right sinus of Valsalva (R-II-B subtype) and transverse trunk coursed between aorta and pulmonary artery. The clinical significance and subtype of the single coronary artery are discussed.     

Ring formation of the internal iliac artery

We observed an arterial ring communicating the superior and inferior gluteal arteries in the left half of the pelvis of an 88-year-old male. Although many previous studies have shown variations in the internal iliac artery, there has been no literature describing the fenestration. Therapeutic embolization is commonly performed for intractable bleeding in pelvic region. Surgeons should be aware of the arterial ring formation because of possible danger in the intravascular treatments. In patients with similar arterial rings, embolization of the anterior trunk of the internal iliac artery could be insufficient when blood runs through the circle of the arterial ring.     

Clinical significance of understanding lateral and medial circumflex femoral artery origin variability

The common femoral artery (CFA) divides into the superficial femoral artery (SFA) and deep femoral artery (DFA). The lateral circumflex femoral artery (LCFA) and medial circumflex femoral artery (MCFA) are most often branches of the DFA, although a large number of different variations in their origin has been described. We performed microdissection on both lower limbs of 30 fetuses, gestational age from 7 to 10 lunar months. Our results show that the LCFA and MCFA usually arise from the DFA. In 78.3% of cases, the MCFA originated from the DFA. In 11.7% of cases, the MCFA originated from the CFA, and in 5% of cases from the SFA. One case showed a common trunk with the DFA. Also, the MCFA was missing in one case, and it had a common trunk with the LCFA in one case. In 83.3% of cases, the LCFA arose from the DFA and in 6.7% of cases from the CFA. In one case, it had a common trunk with the DFA, and in one case with the MCFA. In 3.3% of cases, the LCFA was missing. In 66.7% of cases, both arteries originated from the DFA, in 15% of cases one originated from the DFA and the other from the CFA or SFA. Our results are in accordance with some published studies but also differ from the outcomes of other studies. Comprehensive knowledge of different variation types is imperative in order to prevent complications during surgical and orthopedic interventions.     

骨盆骨折出血动脉栓塞的解剖学基础

目的：了解骨盆动脉侧枝吻合特点，探讨骨盆骨折损伤血管的动脉栓塞的方法。方法：20具新鲜成人骨盆，采用前后双侧入路解剖，观察髂内外血管的走行特点、各动脉间的侧枝吻合情况。结果：骨盆动脉起点口径小于3mm的血管有闭孔动脉、髂腰动脉、骶外侧动脉。骨盆动脉起点口径3～5mm的血管有臀上动脉、臀下动脉、阴部内动脉。骨盆动脉起点口径大于5mm的血管有髂总动脉、髂内动脉、髂外动脉。距骨壁距离大于10mm的血管有髂总动脉、髂内动脉、髂外动脉。距骨壁距离小于10mm的血管有闭孔动脉、髂腰动脉、骶外侧动脉、臀上动脉、臀下动脉。骨盆动脉分支间有广泛的吻合支。结论：骨盆骨折动脉损伤应栓塞损伤的动脉及其主要的侧枝循环。     

成年男性脐动脉的应用解剖

目的 研究男性标本脐动脉的解剖学特点,为临床膀胱癌切除术中结扎脐动脉提供理论依据。 方法 随机选用福尔马林液固定的成年男性尸体19具（38侧）,解剖观测脐动脉的起点、走行、起始端外径及分支,结果进行统计学分析。 结果 脐动脉均起自髂内动脉。脐动脉起始端外径为（3.02±0.30）mm。脐动脉均发出膀胱上动脉,其分支有5种类型：数支膀胱上动脉型,占总标本量的52.6%（20侧）;数支膀胱上动脉和1支膀胱下动脉型,占28.9%（11侧）;2支膀胱上动脉、1支膀胱下动脉与闭孔动脉的共干动脉型,占5.3%（2侧）;数支膀胱上动脉和1支闭孔动脉型,占7.9%（3侧）;2支膀胱上动脉和1支精囊动脉型,占5.3%（2侧）。 结论 脐动脉起始位置固定,起始端外径狭小,分支数目变异较多,对膀胱手术有重要意义。     

骨盆骨折血管损伤的解剖学基础

目的：探讨骨盆骨折血管损伤的机制。方法：20具新鲜成年国人骨盆标本，采用前后双侧入路解剖，观察髂内外血管的走行特点、分型与骨盆韧带、骶丛神经的关系，观察血管在骨盆壁上的投影位置，测量每一根血管到骨壁的垂直距离，观察各动脉间的侧支吻合情况。结果：骨盆动脉血管根据口径可分为3类：(1)小口径动脉，直径小于3．0mm。(2)中等口径动脉，直径3．0～5．0mm。(3)大口径动脉，直径大于5．0mm。据血管距骨壁的距离可分为靠近骨壁的血管(平均距离小于10．0mm)及远离骨壁的血管(平均距离大于10．0mm)。阴部内动脉与骨壁关系不明显。骨盆动脉分支间有广泛的吻合支。结论：骨盆动脉解剖学特点决定了在骨盆骨折中损伤的机率，骨盆动脉有广泛吻合支是骨盆动脉出血止血困难的原因。     

Posterior sinus node artery and accessory atrioventricular node artery arising by a common origin: A case report

We describe herein a rare and hitherto not reported variation, found in a Japanese male cadaver, in which a posterior sinus node (SN) artery and an accessory atrioventricular node (AN) artery originate from a common trunk branching from the posterior segment of the circumflex artery. After arising in this manner, the posterior SN artery passed in a clockwise direction around the posterior, lateral, and finally anterior wall of the left atrium to the sinus venosus, giving off a branch to the SN from posteriorly. The accessory AN artery coursed in a counterclockwise direction on the posterior wall of the left atrium as far as the crux of the heart, where it bent anterosuperiorly and continued within the interatrial septum. It entered the AN from superiorly and, crossing deep to the principal AN artery, reached the inferior and superficial portion of this node. It could be considered that the accessory AN artery in this study is a modified version of arteries entering and coursing in the interatrial septum, as exemplified by Kugel's anastomotic artery. Clin. Anat. 11:106–111, 1998. © 1998 Wiley-Liss, Inc.     

Rare arterial variation: a common trunk from the external iliac artery for the obturator, inferior epigastric and profunda femoris arteries

Summary In this anomaly, observed in the right pelvic region of a female newborn cadaver among 100 studied (1%), a common arterial trunk arose from the medial side of the external iliac a. 1 cm proximal to the inguinal ligament. The trunk first divided into an ascending branch, which finally divided into the obturator and inferior epigastric arteries, and a descending branch, the profunda femoris a. from which arose the medial circumflex femoral a. The origin of the profunda femoris, obturator and inferior epigastric aa. is explained on the basis of the embryologic development and their course and variations are compared with reports in the literature.

---

Une variété artérielle rare : naissance par un tronc commun, issu de l'a. iliaque externe, des aa. obturatrice, épigastrique inférieure et profonde de la cuisse

Résumé L'anomalie rapportée a été observée dans la région pelvienne droite du cadavre nouveau-né d'une petite fille sur 100 cadavres étudiés (1 %). Le tronc artériel commun naissait de la face médiale de l'a. iliaque externe, 1 cm proximalement au ligament inguinal. Le tronc se divisait d'abord en une branche ascendante, qui se divisait ensuite en aa. obturatrice et épigastrique inférieure, et une autre branche descendante, l'a. profonde de la cuisse, dont naissait l'a. circonflexe fémorale médiale. L'origine des aa. profonde de la cuisse, obturatrice et épigastrique inférieure pourrait être expliquées par le développement embryonnaire. Leur trajet et leurs variations sont étudiés à la lumière de la littérature.

     

Accessory inferior thyroid artery and internal thoracic artery originating from the thyrocervical trunk

During the routine dissection of an 87-year-old Caucasian male cadaver, an accessory inferior thyroid artery originating from the left suprascapular artery was detected. In addition to the existence of inferior and superior thyroid arteries, a third thyroid artery arising from the left suprascapular artery was present at the left of these arteries; this artery was determined as the accessory inferior thyroid artery. Again, the left internal thoracic artery arose from the thyrocervical trunk. The internal thoracic artery originated near the thyrocervical trunk’s origin point and descended vertically. The thyrocervical trunk ended near the medial border of the anterior scalene muscle after giving rise to the inferior thyroid, transverse cervical and suprascapular arteries.     

小型猪皮瓣模型的影像解剖学研究

目的:研究小型猪躯干主要皮动脉血液供应,为皮瓣的相关研究提供动物模型和充分的解剖学依据。方法:(1)小型猪5头放血处死,动脉灌注明胶-氧化铅混悬液,运用CT扫描三维重建全身动脉系统。解剖观测躯干主要皮动脉的起源、行程、营养范围以及相互之间的吻合情况,并取下皮肤筋膜组织拍摄X线片。(2)活体小型猪1头静脉注射泛影葡胺,CT扫描三维重建全身动脉系统,与明胶-氧化铅灌注的三维重建行对照观察。结果:在动脉显影X线图像上,可见双侧的腹壁上动脉、肋间动脉穿支、旋髂深动脉构成腹前、侧壁的主要营养链,两两之间有丰富的吻合支,而腹壁下动脉、腹壁浅动脉和胸背动脉均未见粗大的皮肤穿支。全身动脉三维重建图像上,可见躯干主要皮动脉的来源、走行,管径相对大小,并可动态观察血管树的三维结构和相互关系。结论:小型猪躯干体被血运丰富,腹壁上动脉、肋间动脉穿支、旋髂深动脉皮支两两之间有丰富的吻合支,构成躯干体被组织的主要营养链,并可以此设计不同类型的皮瓣。     

The anatomical study on the branches of the femoral artery (II). Comparison with the findings of Adachi's classification

The authors studied the mode of three main branches of the femoral artery (deep femoral, medial circumflex femoral and lateral circumflex femoral artery) in 179 Japanese cadavers during dissecting practice at Gifu University in the last four years. The findings were as follows; Two hundred and seventeen sides in the 352 sides (61.7%) belong to Type I of Adachi's classification on variations in the arrangement of the branches of the femoral artery. Forty-one sides (11.6%) belong to Type II, 55 sides (15.6%) to Type III, 7 sides (2.0%) to Type IV, 8 sides (2.3%) to Type V, 4 sides (1.1%) to Type VI, 5 sides (1.4%) to Type VII and 15 dises (4.3%) to other types. Five cases in 15 sides which belong to other types have been reported in our previous study (Emura et al. 1985). In 3 cases out of 10 sides the deep femoral-medial circumflex femoral trunk, and the ascending and descending branches of the lateral circumflex femoral artery arise from the femoral artery, respectively. In one case out of 10 sides the deep femoral-lateral circumflex femoral trunk and the medial circumflex femoral-inferior epigastric-obturator trunk arise from the femoral artery, respectively. In one case out of 10 sides the lateral circumflex femoral artery and the deep femoral-medial circumflex femoral-inferior epigastric-obturator trunk arise from the femoral artery, respectively. In one case out of 10 sides the medial circumflex femoral-deep circumflex iliac trunk arises from the lateral side of the femoral artery and runs medially behind the femoral artery, and the deep femoral-lateral circumflex femoral trunk arises from the femoral artery. In one case out of 10 sides the deep femoral-ascending (the lateral circumflex femoral artery) trunk, the medial circumflex femoral artery and the deep circumflex iliac-descending (the lateral circumflex femoral artery) trunk arise from the femoral artery, respectively. In one case out of 10 sides the deep femoral-descending (the lateral circumflex femoral artery) trunk, the medial circumflex femoral artery and the ascending branch of the lateral circumflex femoral artery) trunk, the medial circumflex femoral artery and the ascending branch of the lateral circumflex femoral artery arise from the femoral artery, respectively.(ABSTRACT TRUNCATED AT 400 WORDS)     

Rare case of right accessory renal artery originating as a common trunk with the inferior mesenteric artery: a case report

Dissection of a male cadaver revealed several vascular abnormalities in the abdominal cavity, notably of the renal circulation. In particular, three renal arteries were observed on the right side and two on the left. On the right side, one accessory renal artery originated as a common trunk with the inferior mesenteric artery. Additional variations included a left inferior phrenic artery originating from the celiac trunk, bilateral testicular veins emptying into renal veins, and the left testicular artery arising from the left renal artery. The possible embryonic development of these branching patterns and their clinical significance are discussed briefly.     

Rare case of the trunk of the inferior phrenic arteries originating from a common stem with a superior additional left renal artery from the abdominal aorta

We describe in this article a rare case of a 39‐year‐old male with an inferior phrenic arteries trunk (IPAaT) originating from a common stem with a superior additional left renal artery (SAdLRA) from the abdominal aorta as revealed by routine multidetector computed tomography angiography. The IPAaT with an endoluminal diameter at the origin of 2.8 mm had an upward path with a total length of 18.4 mm, forking to the right inferior phrenic artery and left inferior phrenic artery. These two arteries had an endoluminal diameter at the origin of 1.7 mm and 2.0 mm, respectively. The presence of the common stem of the IPAaT with a SAdLRA and the length of the IPAaT complicate selective chemoembolization of the liver parenchyma. Clin. Anat. 25:979–982, 2012. © 2012 Wiley Periodicals, Inc.