Branching patterns of the male internal iliac artery: imaging findings

The aim of this study was to establish the imaging findings of the main branching patterns of the male internal iliac arteries, using different imaging modalities (angio MR, angio CT and digital angiography). Twenty-one males (mean age 73.2 years) underwent imaging evaluation with angio MR, angio CT and digital angiography to define the internal iliac artery anatomy before selective embolization of the pelvic arteries. All three modalities were used in 3 patients, angio MR and digital angiography in 17 patients, angio CT and digital angiography in 6 patients and only angio CT in 1 patient. Internal iliac arteries were classified into four groups using the Yamaki classification (modified from the Adachi's classification). Twenty-six pelvic sides were classified as Group A (61.9%), 13 as Group B (31%) and 3 as Group C (7.1%) with no cases of Group D found. Angio MR, angio CT and digital angiography were able to detect most branches of the internal iliac artery. Group A was the most frequent internal iliac artery branching pattern. Angio CT showed better detailed anatomy than angio MR and digital angiography was considered the gold-standard. Non-invasive vascular imaging with angio MR or angio CT is essential before invasive interventions, allowing better planning of the procedure.