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Anatomy of the internal iliac vein around the sacral promontory based on CT three-dimensional (3D) reconstruction

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Abstract

Introduction and hypothesis

The area around the sacral promontory (SP) is the targeted location of various pelvic operations. We examined the internal iliac vein (IIV) configurations around the SP by computed tomography angiography (CTA) three-dimensional (3D) reconstruction to describe its anatomy and provide accurate anatomical parameters for relevant operations to reduce intraoperative vascular injury.

Methods

We retrospectively studied 2078 CTA 3D model datasets from Nanfang Hospital patients examined for gynecological diseases from December 2009 to October 2020. The IIVs of the above cases were divided into standard and variant IIVs, and variant IIVs were subdivided into different subtypes. To compare the size of the avascular area around the SP between standard and variant IIVs, we selected the two subtypes with the highest variation rate for comparison with the standard IIV type.

Results

The most common types of variant IIVs were 5a (5.15%) and 3a (5.05%). The results showed larger values in the standard group than in the 3a and 5a groups for the confluence of common iliac vein (CCIV) height (37.73±12.05 vs. 28.93±10.17 vs. 27.27±7.58 mm, P < 0.05), distance between the iliac vessels (49.47±9.47 mm vs. 37.08±9.36 vs. 37.73±8.94 mm, P < 0.05), and SP exposure width (44.94±6.39 mm vs. 36.83±8.29 vs. 36.93±7.91, P < 0.05).

Conclusions

Variant IIVs may increase the risk of surgery by reducing the avascular area compared with standard IIVs. Therefore, when operating around the SP, special attention should be given to variant IIVs and avoiding vascular injury.

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Acknowledgments

The study was supported by the Guizhou Provincial Health Commission Science and Technology Fund (gzwkj2021-303), Guizhou Provincial People’s Hospital Talent Fund ([2022]-20), the National Natural Science Foundation of China (Grant No. 81571422), and the Clinical Research Startup Program of the Southern Medical University by High-level University Construction Funding of Guangdong Provincial Department of Education, China (LC2016ZD019).

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Author notes

  1. Ping Shen and Jiaxin Fu contributed equally to this work.

Authors and Affiliations

  1. Department of Gynecology, Guizhou Provincial People’s Hospital, Guiyang, Guizhou, China

    Ping Shen

  2. Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, No. 1838, Guang Zhou Northern Avenue, GuangZhou, 510515, China

    Ping Shen, Jiaxin Fu, Wenling Zhang, Ting Wen, Chunlin Chen & Ping Liu

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  1. Ping Shen
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Contributions

Ping Shen: data collection, analysis and interpretation, manuscript writing and editing

Jiaxin Fu: data collection, analysis and interpretation, manuscript writing and editing

Ping Liu: project development, data management, and manuscript editing

Chunlin Chen: project development, technical guidance, manuscript writing and editing

Wenling Zhang: data collection

Ting Wen: data collection

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Correspondence to Chunlin Chen or Ping Liu.

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Shen, P., Fu, J., Zhang, W. et al. Anatomy of the internal iliac vein around the sacral promontory based on CT three-dimensional (3D) reconstruction. Int Urogynecol J 34, 2257–2263 (2023). https://doi.org/10.1007/s00192-023-05500-w

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  • DOI: https://doi.org/10.1007/s00192-023-05500-w

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