The internal iliac artery
distill to the point of ligation is never emptied of blood.
Following ligation of internal iliac artery
, there is a reduction of 85% in pulse pressure and 48% in the blood flow in the arteries distal to the ligation.
It was given off at a distance of 8mm, from the point of bifurcation (into anterior and posterior division) of the left internal iliac artery
. It gave one muscular branch at a distance of 44 mm, from its origin and a small branch tothe head of the femur.
The origin of superior gluteal artery was different from normal; it came from anterior division of internal iliac artery
DISCUSSION: Bilateral internal iliac artery
ligation is an effective life-saving method to control obstetrical and gynecological hemorrhage and a hysterectomy can often be avoided.
SHEIKH&FADUL (8) and EVANS (9) reported 29% and 57% patients respectively required hysterectomy after ligation of bilateral internal iliac artery
A 3-mm (nominal balloon diameter) Occlusion Balloon Catheter (Transform, Stryker, Natick, MA) was advanced and inflated just distal to the obturator artery origin, temporarily occluding the distal internal iliac artery
. Contrast was injected through the guiding catheter to ensure complete occlusion (Figure 2).
of Cases 1 Medical management 4 2 Figure-of-eight sutures over placental 6 implantation site 3 B/L uterine artery ligation 7 4 Intrauterine packing 2 5 B/L internal iliac artery
ligation 1 6 Obstetric hysterectomy 7 Table 8.
However, some states or illnesses such as endometriosis, congenital diseases of connective tissue that result in less valuable artery walls, such as Ehlers-Danlos syndrome type IV, as well as congenital malformations of blood vessels such as aneurysm, including aneurysm of the internal iliac artery
, may cause arterial rupture in pregnancy or in non-pregnant patients (3-8).
Prompt surgical interventions like hemostatic sutures in placental bed, uterine and internal iliac artery
ligation and application of B-lynch suture in combination with quick resuscitation, management and expertise of a surgeon minimizes morbidity and mortality19,20.
(ii) 55 mm or more for thoracoabdominal aneurysms diameter and presence of giant aneurysm (>35 mm) affecting internal iliac artery
for iliac artery aneurysms.
Care needs to be taken, however, during the approach for UAE because the main access to the internal iliac artery
for embolization is via the contralateral femoral artery and external iliac artery.