Origin of the Obturator Artery: Insights from Donor Studies

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Co-authors:

Milena Douglas - Midwestern University; Colton Lane - Midwestern University; Matthew Mckoy - Midwestern University; Jonathan Rozeboom - Midwestern Unviersity; Eshwar Karupakula - Midwestern University; Harsh Patel - Midwestern University; Kianna Ruble - Midwestern University; Timothy Campbell - Midwestern University; Terrence Ritzman - Midwestern University; Heather Smith - Midwestern University; Leigha Lynch - Midwestern University

Abstract Body : The obturator artery (OA) typically branches from the anterior division internal iliac artery (IIA), running anteriorly and inferiorly along the lateral pelvic wall before entering the obturator canal. The OA supplies various pelvic structures, such as the obturator muscles and the obturator membrane. The OA also supplies muscles in the medial compartment of the thigh, such as the adductor muscles, the pectineus and the gracilis. Alternatively, the OA may arise from the external iliac artery (EIA), most commonly as a branch of the inferior epigastric, running alongside the pecten pubis before entering the obturator canal. In both sexes, the AOA can contribute to collateral circulation in cases of vascular compromise or arterial blockage. The clinical relevance of the obturator artery varies between the sexes: in females, it is significant due to its involvement in pelvic and gynecological procedures, such as hysterectomies or bladder suspension; in males, an OA variant may present increased risk of hemorrhage during inguinal hernia repair or certain prostatectomies. Understanding the variability of this arterial pathway thus becomes critical in the clinical setting. We examined the OA origins in 81 donors from Midwestern University's Glendale (AZ) and Downers Grove (IL) campuses to assess the frequency of the EIA vs IIA variants. Our study revealed that the EIA variant was present in 27 donors (33.3%). Interestingly, this variation occurred more frequently in females (19; 23.5%) compared to males (8; 9.9%). Furthermore, we observed that bilateral aberrant obturator artery (AOA) was exclusively found in female donors (3; 0.05%) at the AZ campus anatomy lab. These findings suggest that bilateral prevalence of AOA may be previously underestimated, particularly among females. This variation could pose an increased risk of complications in cases of pelvic trauma or during retropubic surgeries, making the OA candidate for further clinical consideration.