Bilateral Aberrant Uterine Arteries and Clinical Significance With Uterine Embolization

Abstract

Uterine artery embolization (UAE) under angiographic guidance is the safe and most appropriate treatment option for the management of life-threatening intractable postpartum and gynecological bleeding when other options are not successful in controlling the hemorrhage. In most cases, the uterine artery (UA) is a direct branch of the anterior division of the internal iliac artery (IIA). It is important to be aware of the supplemental arterial supply of the uterus by aberrant UAs. Non-embolization of aberrant UAs supplying the uterus may be a major pitfall in the management of uterine bleeding. A 75-year-old female cadaver in the present study showed two UAs arising from the IIA bilaterally. The normal UA was not tortuous and was a direct branch of the anterior division of the IIA. It reached the cervix of the uterus and ascended in the broad ligament on the lateral margin of the uterus to supply it. Before the IIA was split into anterior and posterior divisions, it gave an additional tortuous branch, which directly approached the fundus of the uterus thereby supplying the superior part of the uterus, the fallopian tube and the ovary. This was the aberrant UA. The normal and aberrant UAs showed anastomosis with each other at the junction of the body of the uterus and cervix. Interventional radiologists and surgeons performing the normal UAE should be aware of this additional aberrant UA variation supplying the uterus.

J Clin Gynecol Obstet. 2023;12(2):65-69
doi: https://doi.org/10.14740/jcgo883