A low level of division was seen in the truncus profundocircumflexus medialis type of division and was
located a maximum of 52 mm distal from the femoral artery bifurcation.

 

The obturator artery has
many variations in its topography. Normally, it arises from the iliac internal
artery with other branches like the gluteus superior artery and gluteus
inferior artery. In its course through the obturator foramen, it anastomoses
with the pubic branch of the inferior epigastric artery arising from the external
iliac artery. Atypically, the pubic branch of the inferior epigastric artery is
the dominant vessel of that anastomosis and the original obturator artery is
atrophic or absent. In this atypical situation, the obturator artery arises
from the inferior epigastric artery or directly from the external iliac artery.
An anastomosis located around the pubic bone is called corona mortis because of
the high risk of iatrogenic damage during several surgical and orthopedic
procedures.9,10

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In our study, a normal origin
of the obturator artery from the internal iliac artery was observed in 67% of
patients (67/100), and an atypical origin called corona mortis was observed in
33% of patients (33/100).

The incidence of an atypical
division of the obturator artery on both sides was seen in 52% of patients
(17/33). In 48% of patients it was seen only on one side (on the right in 9/16
patients and on the left in 7/16 patients) (Table 2).

 

Incidence of corona mortis
anastomosis
 

33% (33/100)

Incidence of corona mortis
bilaterally
 

52% (17/33)
 

Incidence of corona mortis
unilaterally

48% (16/33) 
–         
right  9/16 

–         
left  7/16 

Tab. 2
Variations in the atypical origin of the obturator artery

 

As mentioned above, no mean trunk of
the MFCA was found in 1 case.

In that case, the obturator artery originating atypically from the
inferior epigastric artery was well contrasted. After its common origin with
the inferior epigastric artery, the obturator artery took the course around the
superior margin of the ramus superior of the pubic bone, then entered the
obturator foramen and went toward the minor trochanter, where it anastomosed
with the piriformis branch of the inferior gluteal artery.