Pelviarteriographic anatomy and its the clinical significance

Objective: To study the pelviarteriographic anatomy and find the best projected position for interventional catheterization so as to improve its successful rate. Methods:Aortography( in level of lumber 4) and bilateral common iliac arteriography were taken in 51 normal adults.The common iliac arteriographs were observed and the angles between bilateral common iliac arteries were measured respectively in male and female group, the arising altitude of internal iliac arteries were compared. Three projected positions (posteroanterior, ipsilateral oblique and contralateral oblique view) were taken and the aspects of internal iliac arteries were observed.The angiographic manifestations and arteriographic anatomical types were analyzed and concluded. Results: (1) The average angle between bilateral common iliac arteries was (57.22±8.39)° in normal male adults, and (66.41±7.99)° in normal female adults; there was significant difference between male and female groups(P0.01). The angle of bilateral common iliac arteries was larger in female than that in male. Arising of the internal iliac arteries in right was higher than that in left; (2) Contralateral oblique view was the best projected position to show the opening and route of the internal iliac artery; (3) internal iliac arteries had four anatomic types in normal adult. Conclusion: (1) Because of the female patients' larger angle between bilateral common iliac arteries, it is recommended that direct catheterization and Cobra or Headhunter catheter be used with percutaneous femoral artery puncture technique for contralateral iliac procedures, while in male patients, loop catheterization and Simmons ,Yashiro or RH catheter be much better; (2) contralateral oblique position is helpful for superselective catheterization of internal iliac arteries;(3) according to patients' sex and anatomic types of internal iliac arteriography, the characteristic interventional procedures and therapy would better be carried out.