Iliac artery

Most kidney transplant procedures are heterotopic, where the kidney is implanted above the pelvic bone and attached to the patient s iliac artery and vein. The ureter of the transplant kidney is attached directly to the recipient s bladder or native ureter. The native kidneys usually are not removed, and data have shown that under most circumstances, removal of the native kidneys does not influence patient survival and allograft survival. Special circumstances, however, such as renal cell carcinoma and PCKD, may necessitate native kidney removal.1,3 There were 16,477 (9914 deceased donors, 6563 living donors) kidney transplants and 903 simultaneous kidney-pancreas procedures done in 2005.3... 

Dotter CT, Rosch J, Anderson JM, et al. Transluninal iliac artery dilatation nonsurgical catheter treatment of atheromatous narrowing. JAMA 1978 230 117. 

There are many different procedures used for pancreas transplantation, and there is no one standard protocol used in all transplant centers. The important considerations, however, are that the arterial blood flow supply to the pancreas and duodenal segment, and venous outflow from the pancreas via the portal vein should be adequate. The recipient s right common or external iliac artery is used to restore vascularization of the artery in the pancreas. The Y graft of the tissue is anastomosed end-to-side and the venous vascularization is performed either systemically or portally, but mostly it is done with systemic venous drainage. 

The blood supply to the vagina is through the uterine arteries and the internal iliac artery. Blood returns to the venous system through veins that empty into the internal iliac vein. Lymphatic drainage is through the external and internal iliac lymph nodes and superficial inguinal lymph nodes. 

Schurmann K, Vorwerk D, Uppenkamp R, et al. Iliac arteries plain and heparin-coated Dacron-covered stent-grafts compared with noncovered metal stents-an experimental study. Radiology 1997 203(l) 55-63. 

Carter AJ, Farb A, Gould KE, Taylor AJ, Virmani R, The degree of neointimal formation after stent placement in atherosclerotic rabbit iliac arteries is dependent on the underlying plaque, Cardiovasc Pathol 1999 8(2) 73-80. 

Rabbit iliac artery Drug-eluting stent Prevented intimal thickening (56)... 

I 9 Breuss J M, Cejna M, Bergmeister H, et al, Activation of nuclear factor-kappa B significantly contributes to lumen loss in a rabbit iliac artery balloon angioplasty model, Circulation 2002 105 633-638. 

Four weeks after the implantation of bevacizumab-eluting stent in the right iliac artery of a hypercholesterolemic rabbit. Angiographically, there is no detectable intimal hyperplasia. Source From Ref. 71. 

Time-course analysis in a rabbit iliac artery model disclosed <20% stent re-endothelialization at four days, <40% at seven days, and near-complete endothelialization at 28 days following stent implantation (18). The re-endothelialization process has been studied in several other animal models using different types of injuries with very controversial results, suggesting, in part, a diversity in the response and capacity of vascular healing. 

These VEGF-eluting stents were tested in vivo in a rabbit iliac artery model. After seven days, median clot demonstrated was 12.5 mg in control stents versus Omg [P = 0.0142 95% confidence interval (Cl) 8.49, 55.99] in VEGF stents. Quantifiable re-endothelialization was poor in both groups (Fig. 2), with no significant differences between them. Neointimal cross-sectional area at 28 days showed no statistically significant differences (Table I) (24). 

Scanning electron micrograph of a vascular endothelial growth factor (VEGF)-eluting stent in situ in rabbit iliac artery. The artery and stent have been split longitudinally and gently prised open. 

Table 1 Digital morphometry of cross-sections of stented iliac arteries at 28 days using vascular endothelial growth factor and control polymer-coated stents ...

Jenkins MR Buonaccorsi GA, Mansfield R, et al, Reduction in the response to coronary and iliac artery injury with photodynamic therapy using 5-aminolaevulinic acid, Cardiovasc Res 2000 45 478-485. 

Pai M, Jamal W, Mosse A, et al. Inhibition of in-stent restenosis in rabbit iliac arteries with photodynamic therapy. EurJ Vase Endovasc Surg 2005 30(6) 573 581. 

Motarjeme A, Gordon G, Bodenhagen K, Thrombolysis and angioplasty of chronic iliac artery occlusions, J Vase Intervent Radiol 1995 6 665-725. 

The endovascular procedure is most frequently used to treat infrarenal AAAs that are a leading cause of death in the older population, As our population ages, we will encounter AAAs more frequently than ever before. An aneurysm is defined by a size greater than 5 cm or 2.5 times the normal diameter of the native artery. Most aneurysms begin below the renal arteries and end close to the iliac bifurcation. More complicated AAAs exist involving the suprarenal aorta and visceral vessels and extending into the iliac arteries. The prevalence of AAAs is 3% to 10% for patients older than 50 years (I). They occur more frequently in men and reach a peak incidence close to the age of 80 years. AAA rupture is associated with an 80% to 90% mortality rate and therefore the focus of AAA treatment is on intervening before the aneurysm ruptures elective repair has mortality rate of less than 5%. 

Presence or absence of thrombus Distal landing zone diameter and length Iliac arteries presence of aneurysms and occlusive disease Access arteries (common, external and femoral arteries) Diameter, presence of occlusive disease Contraindications for EVAR Short proximal neck... 

Left) Angulated proximal aortic neck (Right) tortuous iliac arteries. 

Carpenter JR Delivery of endovascular grafts by direct sheath placement into the aorta or iliac arteries. Ann Vase Surg 2002 ... 

Larsen DW, Halbach VV, Teitelbaum GP, McDougaU CG, Higashida RT, Dowd CF, Hieshima GB (1995) Spinal dural arteriovenous fistulas supplied by branches of the internal iliac arteries. Surg Neurol 43 35-40 discussion 40-1 Lasjaun ias P, Berenstein A, ter Brugge KG (2001) Surgical Neu-... 

Spiller W (1909) Thrombosis of the cervical anterior median spinal artery. I Nerv Ment Dis 36 601 Stein SC, Ommaya AK, Doppman JL, Di Chiro G (1972) Arteriovenous malformation of the cauda equina with arterial supply from branches of the internal iliac arteries. Case report. J Neurosurg 36 649-651 Stepper F, Lovblad KO (2001) Anterior spinal artery stroke demonstrated by echo-planar DWI. Eur Radiol 11 2607-2610 Suh T.H., Alexander L (1939) Vascular system of the human spinal cord. Arch Neurol Psychiat 41 659-677 Suzuki T, Kawaguchi S, Takebayashi T, Yokogushi K, Takada J, Yamashita T (2003) Vertebral body ischemia in the posterior spinal artery syndrome case report and review of the literature. Spine 28 E260-264... 

Inoue et al. (1990) induced experimental atherosclerosis in the rat carotid artery by balloon de-endothelialization and atherogenic diet. A balloon catheter was introduced into the rat s carotid arteries from the iliac arteries and the endothelium was denuded. 

A study of the aorta and coronary carotid and iliac arteries. British Medical Journal L1293-1301... 

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