Superior gluteal artery

Course

In the majority of the population, the superior gluteal artery arises from the posterior trunk of the internal iliac artery and is essentially its continuation. The artery extends posteriorly between the lumbosacral trunk of the sacral plexus and the first sacral spinal nerve, or between the first and second sacral spinal nerves.

The artery then takes a more inferior trajectory to leave the pelvis via the greater sciatic foramen, superior to piriformis muscle. Here it splits into its superficial and deep terminal branches. The superficial branch travels between the superficial surface of the gluteus medius and the deep surface of gluteus maximus, while the deep branch travels along the deep surface of the gluteus medius.

Branches and supply

After arising from the posterior trunk and before exiting the pelvis via the greater sciatic foramen, the superior gluteal artery supplies the piriformis and obturator internus muscles and gives a nutrient branch to the ilium. After leaving the greater sciatic foramen, the artery splits into two terminal branches.

• The superficial branch gives off several branches that contribute to the blood supply to the gluteus maximus muscle by forming several anastomoses with the branches of the inferior gluteal artery. Via these anastomoses, the branches of the superior gluteal artery provide about one-third of the blood supply to the gluteus maximus, although sometimes it can be its main supplying vessel. The superficial branch also gives off several twigs that pierce the tendinous, medial, part of the gluteus maximus muscle and anastomose with branches of the lateral sacral arteries and supply the skin over the sacrum.
• The deep branch splits into two branches.
  • The superior branch travels along the pelvic attachment of the gluteus minimus to anastomose with the ascending branch of the lateral circumflex femoral artery and the deep circumflex iliac artery.
  • The inferior branch travels between the gluteus medius and minimus muscles and supplies them both, as well as the superior part of the tensor fasciae latae. Here it anastomoses with the lateral circumflex femoral artery. It extends a branch to the trochanteric fossa, where it anastomoses with the inferior gluteal artery and ascending branch of the medial circumflex femoral artery. Some branches supply the hip joint.

The superior gluteal artery sometimes also contributes to the vascular supply of the superior gemellus muscle.

Anatomical variation

Most commonly, the superior gluteal artery arises as a separate branch of the internal iliac artery. On rare occasions, it shares a common origin with other branches of the internal iliac artery; inferior gluteal, internal pudendal and umbilical arteries.

Sometimes, when the superior gluteal artery is a separate branch, it will give rise to the obturator artery, which is most commonly a branch of the internal iliac artery.