Evaluation of the arterial kink point during flexion of the hip: A dynamic angiographic study in iliac endofibrosis patients.

Abstract

The aim of the study was to determine the flexion point's location of the ilio-femoral arterial axis and its angulation. Thirty-seven dynamic digital subtraction angiographies were analyzed and were included in the current study. Different lengths were measured, based on specific anatomical landmarks: the origin of the external iliac artery, the inguinal ligament and the bifurcation of the femoral artery. These lengths were measured in extension and during flexion of the hip in order to determine the flexion point of the artery. In extension, some physiological angulations of the external iliac artery were measured. During flexion of the hip joint, the distance from the kink point to the bifurcation of the common iliac artery was respectively 82 ± 21mm (range 48-116) on the right side and 95 ± 20mm (range 59-132) on the left side. The distance from the kink point to the inguinal ligament was respectively 38 ± 40mm (range 12-138) on the right side and 26 ± 23mm (range 8-136) on the left side. The distance from the kink point to the bifurcation of the femoral artery was respectively 45 ± 29mm (range 15-107) on the right side and 27 ± 12mm (range 10-66) on the left side. During flexion, the angulation of the flexion point of the ilio-femoral axis was 114 ± 18° (range 81-136°). The flexion point was located cranially to the inguinal ligament and below the departure of the external iliac artery.