Faculty of Medicine, Department of Radiology, Eskişehir Osmangazi University, 26040, Eskisehir, Turkey.
Surg Radiol Anat. 2023 Dec;45(12):1545-1550. doi: 10.1007/s00276-023-03252-2. Epub 2023 Oct 23.
To describe a case of an anomalous common iliac artery (CIA) arising from the aorta as the fourth lumbar artery (4th LA) and following a retro-psoas course as the continuation of the 4th LA.
Contrast-enhanced abdominopelvic computed tomography (CT) findings of an incidentally detected anomalous CIA are described in an 8-year-old girl.
CT showed that the right CIA originated from the distal aorta at the L3-L4 level with an acute angle and continued posteriorly in the course of the 4th LA. The right CIA descended into the iliac fossa as a single artery, lying posterior to the psoas muscle. It gave off the internal iliac artery (IIA) low in the iliac fossa and continued as the external iliac artery (EIA). The median sacral artery (MSA) originated from the left proximal CIA and joined the posterior division of the right IIA.
Fourth LA continuation of the CIA is a rare vascular anomaly with a few published reports to date. The anomaly occurs far more on the right side than the left and is mostly asymptomatic. An abnormal connection between the umbilical artery and the distal aorta probably results in this anomaly, as well as in another group of CIA anomalies that are characterized by the absence of one or two CIAs with trifurcation or quadrifurcation of the distal aorta.
Although the vascular anomaly is mostly asymptomatic, knowledge of it is important in the interventions of the area to prevent complications.
描述一例罕见的异常髂总动脉（CIA）起自主动脉作为第四腰动脉（4th LA），并沿着腰大肌后走行作为 4th LA 的延续。
描述一名 8 岁女孩偶然发现的异常 CIA 的增强腹部 CT 表现。
CT 显示，右侧 CIA 在 L3-L4 水平从主动脉远端以锐角起源，并沿 4th LA 的后向走行。右侧 CIA 下降至髂窝，作为单一动脉，位于腰大肌后方。它在髂窝内发出髂内动脉（IIA），并继续作为髂外动脉（EIA）。正中骶动脉（MSA）起源于左侧 CIA 近端，并与右侧 IIA 的后部分支汇合。
CIA 的第四腰动脉延续是一种罕见的血管异常，迄今为止仅有少数文献报道。该异常在右侧比左侧更为常见，且大多无症状。脐动脉与主动脉远端之间的异常连接可能导致这种异常，以及另一组 CIA 异常，其特征为一个或两个 CIA 缺失，伴有远端主动脉的三分叉或四分叉。
尽管血管异常大多无症状，但了解该异常在该区域干预中的重要性可预防并发症。
