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Congenital anomaly of the external iliac artery: a case report
Teruyuki Koyama1, Tadanori Kawada, Yosuke Kitanaka
1Division of Cardiovascular Surgery, Department of Surgery, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki 216-8511, UJapan. t2koyama@jikei.ac.jp
Insights
A rare congenital absence of the left external iliac artery was found in a 51-year-old man presenting with acute leg ischemia. This anatomical variation required surgical intervention for thrombus removal.
Area of Science:
- Vascular Surgery
- Anatomical Variations
- Ischemic Limb Disease
Background:
- Acute limb ischemia presents a significant vascular emergency.
- Congenital anatomical variations can predispose individuals to vascular complications.
- Understanding iliofemoral anatomy is critical for diagnosing and treating peripheral artery disease.
Observation:
- A 51-year-old male presented with severe left leg ischemic pain.
- Angiography revealed absence of the left external iliac artery.
- The left internal iliac artery appeared to be the primary conduit to the left common femoral artery.
Findings:
- Surgical exploration confirmed the absence of the left external iliac artery.
- The left common iliac artery directly transitioned into a dilated left internal iliac artery, supplying the left common femoral artery.
- Thrombi occluded the left superficial and proximal deep femoral arteries.
Implications:
- This case highlights a rare congenital anomaly mimicking iliofemoral occlusive disease.
- Accurate preoperative diagnosis of anatomical variations is crucial for successful surgical planning.
- Management strategies for acute limb ischemia must consider unusual vascular configurations.
Abstract:
A 51-year-old man was admitted with acute ischemic pain in the left leg. An angiogram demonstrated a well-developed left internal iliac artery that appeared to be continuous with the left common femoral artery, but no left external iliac artery. The left superficial and proximal deep femoral arteries were obstructed with thrombi. At surgery it was revealed that the distal end of the left common iliac artery was continuous with the dilated left internal iliac artery, forming the continuation with the left common femoral artery in the pelvic cavity. The left external iliac artery was absent between the common iliac and femoral arteries.