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Superior Gluteal ArteryEdit

The superior gluteal artery is a primary vessel of the pelvis and the gluteal region, delivering the main arterial blood supply to the buttock muscles and contributing to the vascularization of the hip joint. It most commonly originates as a major branch of the posterior division of the internal iliac artery and follows a course that takes it out of the pelvic cavity through the greater sciatic foramen, usually superior to the piriformis muscle and alongside the superior gluteal nerve. In the gluteal region it divides into superficial and deep branches that supply the gluteal muscles and participate in a network of anastomoses around the hip. The artery’s predictable course and relationships with surrounding muscles and nerves make it a critical structure in orthopedic and vascular procedures involving the pelvis and hip.

Anatomy

Origin and course

The superior gluteal artery typically arises from the posterior division of the internal iliac artery and exits the pelvis via the greater sciatic foramen, passing superior to the piriformis. After emerging, it runs between the gluteus medius and gluteus minimus muscles, often accompanied by the superior gluteal nerve. The artery then fans out in the gluteal region to supply both deep and superficial structures of the buttock.

Branches

The artery divides into two main trunks within the gluteal region: - superficial branch: travels near the surface of the gluteus maximus to supply the superficial aspects of the buttock skin and the superficial fibers of the gluteus maximus; it also participates in cutaneous and muscular anastomoses. - deep branch: penetrates between the gluteus medius and gluteus minimus to provide arterial supply to the gluteus medius, gluteus minimus, and, to a lesser extent, the tensor fasciae latae. The deep branch also gives articular branches to the hip joint and forms anastomoses with branches from the inferior gluteal artery and nearby arteries.

Relations and anastomoses

In the hip region the superior gluteal artery forms important anastomotic connections with branches of the inferior gluteal artery and with arteries accompanying the femoral neck and hip joint. Its proximity to the superior gluteal nerve, which typically travels with it or in close relation, is clinically relevant during surgical approaches to the hip and in procedures involving the gluteal muscles.

Function and distribution

  • gluteus maximus: the superficial branch supplies portions of the muscle and overlying skin.
  • gluteus medius and gluteus minimus: the deep branch provides primary supply to these abductors, essential for pelvic stability during walking.
  • tensor fasciae latae: sometimes receives a contribution from the deep branch.
  • hip joint: articular branches contribute to the vascular supply of the hip capsule and related structures.

The vascular network created by the superior gluteal artery and its anastomoses helps protect the gluteal region from ischemia in the setting of localized arterial occlusion and supports collateral flow if primary pathways are disrupted.

Clinical significance

Injury and surgical relevance

Because the superior gluteal artery lies in the gluteal region adjacent to the hip joint, it is encountered in ortho-ped(ic) procedures around the pelvis and hip, including arthroplasty, fracture fixation, and soft-tissue reconstructions. Blunt or penetrating trauma to the buttock, pelvic fractures, or iatrogenic injury during surgery can result in laceration or rupture of branches of the superior gluteal artery, with potential retroperitoneal or intramuscular bleeding and hematoma formation. Knowledge of its typical course helps reduce the risk of inadvertent injury during sacroiliac, hip, or intramuscular procedures.

Injections and clinical practice

Injections into the gluteal region should be performed with awareness of the surrounding vascular and neural structures. Although the gluteal region remains a common site for intramuscular injections, targeting the upper outer quadrant to avoid vascular structures minimizes the chance of damaging the superior gluteal vessels or nerves. The arterial supply to the buttock and hip region underscores the importance of careful technique and anatomical orientation in everyday clinical practice.

Imaging and interventional considerations

In cases of traumatic bleeding or complex pelvic pathology, imaging-based localization of the superior gluteal artery can guide interventions such as selective embolization or surgical repair. Advanced imaging modalities, including CT angiography and MR angiography, can delineate the artery’s course and its relationship to adjacent structures when planning procedures.

Variations

There is some anatomical variation in the origin and branching pattern of the superior gluteal artery. While the classic description is an origin from the posterior division of the internal iliac artery with division into superficial and deep branches in the gluteal region, occasional variants include: - origin from a common trunk with other gluteal branches. - variation in the precise point of exit relative to the piriformis. - differences in the size and extent of the superficial versus deep branches.

Such variations have practical implications for surgical planning and radiologic interpretation in the pelvis and hip region.

Imaging and diagnostics

Imaging of the superior gluteal artery is most informative when assessing vascular integrity after trauma or in planning interventions around the hip. Key modalities include: - CT angiography: provides rapid, high-resolution visualization of the artery, its branches, and potential sites of injury. - MR angiography: useful in patients for whom ionizing radiation is a concern or when contrast use is limited. - Digital subtraction angiography: remains a gold standard for detailed vascular mapping and for performing therapeutic embolization if indicated.

See also