Abstract
Background and importance
The median sacral artery (MSA) is a relatively small vessel that always arises from the posterior, terminal part of the infrarenal aorta. In most cases, the MSA runs behind the iliocaval junction. Here, we describe a very rare case of an MSA running in front of this junction.
Case report
During a human cadaveric dissection of the retroperitoneal area, we unexpectedly observed that the MSA passed in front of the left common iliac vein.
Conclusion
The anatomy of the MSA has been extensively described and variations are quite rare. On the basis of this specific case, knowledge of the anatomic interactions between the MSA and other lumbar retroperitoneal vessels may help to avoid potential complications during surgery.
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References
Barksdale PA, Elkins TE, Sanders CK et al (1998) An anatomic approach to pelvic hemorrhage during sacrospinous ligament fixation of the vaginal vault. Obstet Gynecol 91:715–718
Barrey C, Ene B, Louis-Tisserand G et al (2013) Vascular anatomy in the lumbar spine investigated by three-dimensional computed tomography angiography: the concept of vascular window. World Neurosurg 79:784–791. doi:10.1016/j.wneu.2012.03.019
Beveridge TS, Power A, Johnson M et al (2015) The lumbar arteries and veins: quantification of variable anatomical positioning with application to retroperitoneal surgery. Clin Anat N Y 28:649–660. doi:10.1002/ca.22504
Flynn MK, Romero AA, Amundsen CL, Weidner AC (2005) Vascular anatomy of the presacral space: a fresh tissue cadaver dissection. Am J Obstet Gynecol 192:1501–1505. doi:10.1016/j.ajog.2004.11.019
Garg J, Woo K, Hirsch J et al (2010) Vascular complications of exposure for anterior lumbar interbody fusion. J Vasc Surg 51:946–950. doi:10.1016/j.jvs.2009.11.039 (discussion 950)
Kiev J, Dupont JR, Kerstein MD (1996) Injury of a medial sacral vessel during lumbar laminectomy. Ann Vasc Surg 10:63–65. doi:10.1007/BF02002344
Sae-Jung S, Khamanarong K, Woraputtaporn W, Amarttayakong P (2015) Awareness of the median sacral artery during lumbosacral spinal surgery: an anatomic cadaveric study of its relationship to the lumbosacral spine. Eur Spine J Off Publ Eur Spine Soc Eur Spinal Deform Soc Eur Sect Cerv Spine Res Soc 24:2520–2524. doi:10.1007/s00586-014-3641-z
Samudrala S, Khoo LT, Rhim SC, Fessler RG (1999) Complications during anterior surgery of the lumbar spine: an anatomically based study and review. Neurosurg Focus 7:e9. doi:10.3171/foc.1999.7.6.10
Tribus CB, Belanger T (2001) The vascular anatomy anterior to the L5–S1 disk space. Spine 26:1205–1208
Young AH (1897) Abnormalities of the middle sacral artery, and their morphological significance. J Anat Physiol 31:169–175
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Chenin, L., Tandabany, S., Foulon, P. et al. A median sacral artery anterior to the iliocaval junction: a case report—anatomical considerations and clinical relevance for spine surgery. Surg Radiol Anat 40, 115–117 (2018). https://doi.org/10.1007/s00276-017-1917-9
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DOI: https://doi.org/10.1007/s00276-017-1917-9