A 53-year-old man is hospitalized due to chest pain and palpitations. Cardiac catheterization is planned to evaluate for coronary artery disease. The femoral artery is palpated in the right groin, and a catheter is introduced into the common femoral artery. The associated vasculature is visualized after injecting a contrast agent into the catheter. Which of the following is most likely the artery indicated by the arrow in the image above?

Question

A 53-year-old man is hospitalized due to chest pain and palpitations.  Cardiac catheterization is planned to evaluate for coronary artery disease.  The femoral artery is palpated in the right groin, and a catheter is introduced into the common femoral artery.  The associated vasculature is visualized after injecting a contrast agent into the catheter.  Which of the following is most likely the artery indicated by the arrow in the image above?

Quizplus · Accepted Answer

11ec160b_3558_676e_9249_f91c829a6228_MD0001_00 As the aorta courses through the lower abdomen, it divides into the common iliac arteries, which subsequently branch into the internal and external iliac arteries. The inferior epigastric artery branches off from the external iliac artery immediately proximal to the inguinal ligament before the external iliac artery becomes the common femoral artery. As the inferior epigastric artery runs superiorly and medially up the abdomen, it provides blood supply to the lower anterior abdominal wall. The other main branch off the external iliac artery is the deep circumflex iliac artery, which branches more laterally but also supplies blood to the lower abdominal wall. (Choices B, D, and E) The internal iliac artery supplies most of the structures of the pelvis, gluteal region, and medial thigh. The obturator artery is a branch of the internal iliac artery that runs inferiorly to supply blood to the bladder and medial compartment of the thigh. The superior gluteal artery is the continuation of the internal iliac artery and runs inferiorly to supply blood to the gluteal muscles and a portion of the hip. (Choice C) The medial circumflex femoral artery branches off the deep femoral artery to supply blood to the femoral neck. Educational objective: The inferior epigastric artery branches off the external iliac artery immediately proximal to the inguinal ligament. It provides blood supply to the lower anterior abdominal wall as it runs superiorly and medially up the abdomen. __________ References: Percutaneous management of inferior epigastric artery injury after cardiac catheterization. (http://www.ncbi.nlm.nih.gov/pubmed/21538784) Transcatheter coil embolization of the inferior epigastric artery in a huge abdominal wall hematoma caused by paracentesis in a patient with liver cirrhosis. (http://www.ncbi.nlm.nih.gov/pubmed/22102392) Retroperitoneal hemorrhage caused by inferior epigastric artery injury. (http://www.ncbi.nlm.nih.gov/pubmed/26231679)

A 53-Year-Old Man Is Hospitalized Due to Chest Pain and Palpitations