Anatomy - Right above-knee amputation for Fontaine stage IV peripheral arterial disease (PAD)

Anatomy Perioperative management Technique Complications Evidence Total Video

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Authors

Edith Leisten

MVZ St. Marien Köln - Ärztliche Leiterin

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Arterial supply of the pelvis

The abdominal aorta divides at the aortic bifurcation (approximately at level L4) into the two common iliac arteries
Each common iliac artery in turn divides into an internal and an external iliac artery
With its visceral branches, the internal iliac artery supplies predominantly the pelvic viscera, while with its parietal branches it contributes to the blood supply of the lower extremities
The external iliac artery contributes to the pelvic blood supply and, after passing through the vascular compartment (lacuna vasorum), becomes the femoral artery

Origin	Arises from the common iliac artery immediately inferior to the aortic bifurcation
Course	Courses caudad over the superior border of the greater sciatic foramen
Anatomical relationship	Posterior: internal iliac vein, piriformis muscle, lumbosacral plexus Anterior: ureter Lateral: external iliac vein, psoas major Inferior: obturator nerve
Branches	Visceral branches: Umbilical arteries Inferior vesical artery Middle rectal artery In women: uterine artery Parietal branches: Iliolumbar artery Lateral sacral arteries Superior gluteal artery Inferior gluteal artery Obturator artery Internal pudendal artery
Vascular territory	Pelvic organs, gluteal muscles

Origin	Arises from the common iliac artery caudal to the internal iliac artery
Course	Runs along the psoas major muscle towards the inguinal ligament, passes through the vascular compartment (lacuna vasorum) and here becomes the femoral artery
Anatomical Relationship	The right external iliac artery runs beneath the ureter On the left, the ureter crosses somewhat lower anterior to the bifurcation of the external iliac artery
Branches	The deep circumflex iliac artery runs to the superior iliac spine and anastomoses with the iliolumbar artery and the superior gluteal artery The inferior epigastric artery runs cranially medial to the deep inguinal ring and between the transversus abdominis and rectus abdominis muscles; further branches include the cremasteric artery and the artery of the round ligament of the uterus
Vascular territory	Iliac bone, inferior aspect of the abdominal wall

Arterial blood supply to the lower extremity

1. Femoral artery1.1. OverviewOriginExternal iliac artery, which becomes the femoral artery after p

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