Radiologic anatomy of the anastomotic systems of the internal iliac artery.

On the basis of 200 angiographic studies of atherosclerotic patients affected by aorto-iliac lesions, the authors have investigated the anastomotic collateral systems of the internal iliac artery. After defining the different anastomotic systems of the internal iliac artery, they attempt to assess the functional importance of each anastomotic system in relation to the level of aorto-iliac obstruction. The different anastomotic systems involved are studied in terms of the different types of obliteration of the main arterial axis, and clinical tolerance is assessed for each case. This study emphasizes the important role of the internal iliac artery in the compensatory circulation to the lower limbs, over and above its role as an artery supplying the pelvis. The authors consider that this justifies attaching great importance to revascularization of the internal iliac arteries during reconstructive aorto-femoral procedures.