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

  • Waseem Al Talalwah

    Student thesis: Doctoral ThesisDoctor of Philosophy


    The sciatic nerve is the largest nerve in the human body giving both
    motor and sensory innervations to the lower limb. It can be affected in chronic
    diseases, such as diabetes, or compressed anatomically by structures such as
    piriformis and aneurysms leading to sciatica or paralysis of the lower limb. The
    current study therefore focuses on the arterial supply of the sciatic nerve as well
    as its course. Embryologically, the sciatic nerve is supplied via the axial artery
    during the first trimester. As the axial artery regresses, the iliac system
    develops. A failure of sciatic artery regression leads to several variations of
    pelvic and femoral arteries, with a risk of iatrogenic injury/trauma for those
    patients undergoing pelvic, gluteal and thigh surgical procedures. An
    understanding of the variability of the pelvic arteries in relation to a coexistent
    sciatic artery will provide an appropriate background for clinicians. The present
    study proposes a new theory of sciatic artery development and persistence, as
    well as new theories for the superior and inferior gluteal, internal pudendal and
    obturator arteries. The thesis is in two parts: first an anatomical study on the
    dissection of 171 cadavers including the pelvic, gluteal and thigh regions to
    observe (i) the patterns of the arteries these regions, and (ii) the course of the
    sciatic nerve. With variable course of sciatic nerve, there is a variability of its
    blood supply. Moreover, it includes a new classification of sciatic nerve with
    respect to clinical implications. The thesis clarifies the origins of the sciatic
    artery and its course. The second part is a literature review of sciatic artery
    aneurysm cases in 171 patients, which clarifies the risk of aneurysm, together
    with its incidence with respect to pathologic finding and associated disorders.
    Radiologists have to be aware of the internal iliac artery classifications to
    be able to alert general surgeons, orthopaedic surgeons, obstetricians,
    gynecologists, and urologists so that they can improve patient management.
    Date of Award2013
    Original languageEnglish
    SupervisorRoger Soames (Supervisor)


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

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