Posterior division of the internal iliac artery: Anatomic variations and clinical applications

April T. Bleich, David D. Rahn, Cecilia K. Wieslander, Clifford Y. Wai, Shayzreen M. Roshanravan, Marlene M. Corton

Research output: Contribution to journalArticlepeer-review

33 Scopus citations


Objective: The objective of the study was to characterize the anatomy of the internal iliac artery (IIA) and its posterior division branches and to correlate these findings to IIA ligation. Study Design: Dissections were performed in 54 female cadavers. Results: Average length of IIA was 27.0 (range, 0-52) mm. Posterior division arteries arose from a common trunk in 62.3% (66 of 106) of pelvic halves. In the remaining specimens, branches arose independently from the IIA, with the iliolumbar noted as the first branch in 28.3%, lateral sacral in 5.7%, and superior gluteal in 3.8%. The average width of the first branch was 5.0 (range, 2-12) mm. In all dissections, posterior division branches arose from the dorsal and lateral aspect of IIA. The internal iliac vein was lateral to the artery in 70.6% (12 of 17) of specimens on the left and 93.3% (14 of 15) on the right. Conclusion: Ligation of the IIA 5 cm distal from the common iliac bifurcation would spare posterior division branches in the vast majority of cases. Understanding IIA anatomy is essential to minimize intra-operative blood loss and other complications.

Original languageEnglish (US)
Pages (from-to)658.e1-658.e5
JournalAmerican journal of obstetrics and gynecology
Issue number6
StatePublished - Dec 2007


  • hypogastric artery ligation
  • internal iliac artery
  • pelvic hemorrhage
  • vascular anatomy

ASJC Scopus subject areas

  • Obstetrics and Gynecology


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