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 (Fig.
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 ligation.
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.
