The vascular variability of the iliac system and clinical diagnosis in radiology and neurology

The sciatic nerve is the largest nerve in the human body giving both<br/>motor and sensory innervations to the lower limb. It can be affected in chronic<br/>diseases, such as diabetes, or compressed anatomically by structures such as<br/>piriformis and aneurysms leading to sciatica or paralysis of the lower limb. The<br/>current study therefore focuses on the arterial supply of the sciatic nerve as well<br/>as its course. Embryologically, the sciatic nerve is supplied via the axial artery<br/>during the first trimester. As the axial artery regresses, the iliac system<br/>develops. A failure of sciatic artery regression leads to several variations of<br/>pelvic and femoral arteries, with a risk of iatrogenic injury/trauma for those<br/>patients undergoing pelvic, gluteal and thigh surgical procedures. An<br/>understanding of the variability of the pelvic arteries in relation to a coexistent<br/>sciatic artery will provide an appropriate background for clinicians. The present<br/>study proposes a new theory of sciatic artery development and persistence, as<br/>well as new theories for the superior and inferior gluteal, internal pudendal and<br/>obturator arteries. The thesis is in two parts: first an anatomical study on the<br/>dissection of 171 cadavers including the pelvic, gluteal and thigh regions to<br/>observe (i) the patterns of the arteries these regions, and (ii) the course of the<br/>sciatic nerve. With variable course of sciatic nerve, there is a variability of its<br/>blood supply. Moreover, it includes a new classification of sciatic nerve with<br/>respect to clinical implications. The thesis clarifies the origins of the sciatic<br/>artery and its course. The second part is a literature review of sciatic artery<br/>aneurysm cases in 171 patients, which clarifies the risk of aneurysm, together<br/>with its incidence with respect to pathologic finding and associated disorders.<br/>Radiologists have to be aware of the internal iliac artery classifications to<br/>be able to alert general surgeons, orthopaedic surgeons, obstetricians,<br/>gynecologists, and urologists so that they can improve patient management.

Name dc:type.qualificationname

Doctor of Philosophy

Level dc:type.qualificationlevel

Doctoral Thesis

Grantor dc:publisher.institution

University of Dundee

Year dc:date.issued

2013

Author dc:creator

• Al Talalwah, Waseem

Advisor dc:contributor.advisor

• Soames, Roger

• Sciatica
• Piriformis syndrom
• Intermittent claudication
• Vascular radiology
• Angiography,
• Sciatic artery theory
• Inguinal hernia
• Sciatic artery aneurysm
• Sciatic nerve classification
• Neurological diseases,

Language dc:language

eng

Identifier

oai:discovery.dundee.ac.uk:studenttheses/1aa955a0-1289-4670-b226-0eea5425ae0b

OAI identifier oai:identifier

oai:discovery.dundee.ac.uk:studenttheses/1aa955a0-1289-4670-b226-0eea5425ae0b