Variations of the Anatomy and Bony Landmarks of Deep Circumflex Iliac Artery in a Select Kenyan Population

Abstract

Background: The deep circumflex iliac artery (DCIA) is a large caliber artery which branches laterally from the external iliac artery (EIA), directly opposite the origin of the inferior epigastric artery (IEA). Population variations have been reported in its origin, length, and branching patterns. These may alter its relationship to palpable surgical landmarks such as the anterior superior iliac spine (ASIS) and the pubic tubercle (PT) which are used to locate the artery preoperatively, thus predisposing it iatrogenic injury. Despite this, there is paucity of data from the Kenyan setting. Study design: Cross-sectional study design. Objective: To determine the variations of the anatomy and bony landmarks of the Deep circumflex iliac artery in a select Kenyan population. Methods: A total of 104 DCIA from 52 formalin fixed adult cadavers were dissected to expose the DCIA, following which its vessel of origin and distance from the ASIS and PT, relation to the inguinal ligament (IL), length and branching patterns were noted. The average of the measurements were calculated. All data were collected and analyzed using Microsoft Excel 2007 (Microsoft Corporation, Redmond, WA). Representative photos of the vessel and its variations were taken. Results: The DCIA was found to be present and bilaterally symmetrical in all cadavers. In all cases observed, it originated as a lateral branch from the EIA (100%), opposite the IEA and directly behind the IL in 98% of the cases. Its average distance from the ASIS along the IL was 7.28 ± 0.99, while it was 5.91 ± 1.03 from the pubic tubercle to its origin. Its length ranged from 3.7 cm to 9.5 cm, with an average length of 3.86 cm in the right limb and 3.67 cm in the left limb. As regards its branching patterns, in 78% of the cases, it bifurcated into the horizontal and ascending branches, in 6%, it trifurcated and in 4%, it divided into more than 3, exhibiting a fine tree-like branching (arborization). Conclusion: The DCIA in our setting exhibited variations from other settings and an increase in awareness of these variations will probably reduce future iatrogenic lesions of the DCIA and its major branches in Kenya.

Evaluating the length, diameter, and stenosis of deep circumflex iliac artery and neighboring arteries based on digital subtraction angiography

“…The result could be different depending on the definition. Sarna et al defined a vertical difference up to 3 mm as being the same height (Sarna et al, 2020). We had similar results as reported before (Ghassemi et al, 2013).…”