Branching patterns of the internal iliac artery and their relationship with sclerotic plaque formation

The common iliac artery (arteria iliaca communis) is the main artery supplying the lower extremities and perineal region. The internal iliac artery (arteria iliaca interna), a major branch of this artery in women, further divides to supply the pelvis and perineal organs and their walls. The frequent occurrence of abnormalities in the branching patterns of the internal iliac artery and the prevalence of atherosclerotic plaques, which can develop as hard or soft depending on calcium density, make interventions in this region clinically critical. The pathologies that impair tissue perfusion, leading to vessel harvesting, and the anatomical expectations necessitate a proper reconnection. Our study focuses on the branching patterns of the internal iliac artery, the detection of morphometric abnormalities, and the analysis of plaque presence and types in these arteries, considering gender and age differences. This ability was achieved by performing retrospective measurements on Computed Tomography Angiography images of a total of 207 individuals (414 across the pelvis), 104 of whom were male and 103 female. Diameter measurements of the common iliac artery and internal iliac artery were taken from the outer wall, perpendicular to the direction of blood flow; measurements were primarily based on the bifurcation points for the common iliac artery and the bifurcation point of the iliac bifurcation for the internal iliac artery. Atherosclerotic plaques were classified as hard and soft according to their density, and their relationship to branching types was established. According to the study results, the rate of atherosclerotic plaque formation was significantly higher in men than in women (p<0.05). Aging significantly increased atherosclerotic plaque formation (p<0.05), and these plaques had a high performance of becoming hard plaques. Plaque formations developed according to branching types, with the right side showing a... Plaque presence in the iliaca communis was most frequently observed in Type 4B (35.3%), while for the a. iliaca interna, the most common branching type with plaque was Type 2B on the right, and Type 3 on the left (30.4%). Only in the left a. iliaca communis was plaque formation significantly higher in Type 3 (p<0.05). This study is one of the most comprehensive studies in the literature examining the branching patterns of the internal iliac artery and whether there is a relationship between these patterns and plaque formation, evaluating them by gender and age group. This information is intended to be of value to anatomists and surgeons, as well as theoretical and it is intended to provide convenience by providing a practical overview.