Atypical kinking and tortuosity anomaly of the common iliac artery: a case report

Alperen Ü. B., Küçük B., Ortadeveci A.

26th National Anatomy Congress, Isparta, Türkiye, 27 - 30 Ağustos 2026, cilt.20, sa.2, ss.117, (Özet Bildiri)

  • Yayın Türü: Bildiri / Özet Bildiri
  • Cilt numarası: 20
  • Basıldığı Şehir: Isparta
  • Basıldığı Ülke: Türkiye
  • Sayfa Sayıları: ss.117
  • Eskişehir Osmangazi Üniversitesi Adresli: Evet

Özet

Objective: This study evaluates a rare case of common iliac artery (CIA) course, kinking, and tortuosity anomaly from morphometric and clinical perspectives, emphasizing its potential to increase iatrogenic injury risks during pelvic and spinal surgeries. Case: In a formalin-fixed male cadaver obtained from the Department of Anatomy at Eskişehir Osmangazi University, the abdominal aorta deviated rightward at 126°. The right CIA-aorta angle was 144°, the left CIA-aorta angle was 197°, and the inter-iliac angle was 34°. The right CIA length was 47.8 mm (straight: 36.2 mm) with a curve angle of 134°. The left CIA length was 63.7 mm (straight: 38.6 mm). Following an initial parallel course, the left CIA exhibited sharp kinking at 38° at the L4–L5 level to return leftward (Tortuosity Index: 1.65). Proximal-mid-distal diameters were 13.5–14.0–13.3 mm for the right CIA and 14.8–16.1–16.3 mm for the left CIA. The angle of divergence between the internal and external iliac arteries was 29° on the right and 42° on the left. Conclusion: The severe tortuosity and atypical kinking morphology of the left CIA, combined with the concurrent megarectum which narrowed the surgical field, hold major clinical significance. It substantially elevates the risk of iatrogenic injury during anterior lumbar interbody fusion (ALIF) and vessel perforation or thrombosis during endovascular repairs (EVAR).

Keywords: common iliac artery, variation, kinking, tortuosity, anatomy