Frequency and demographic variability of the corona mortis: Insights from computed tomography angiography.

Abstract

To determine the frequency, laterality, diameter, and arterial origin of the corona mortis (CM) using computed tomography angiography (CTA) in a large consecutive cohort from two affiliated academic hospitals. A secondary objective was to assess demographic associations with CM, including age, sex, body mass index (BMI), and race or ethnicity. This retrospective study evaluated 988 consecutive abdominal and pelvic CTAs performed between 2020 and 2022 at Parkland Hospital and Clements University Hospital, representing 1976 hemipelvises. All patients aged be ≥ 18 years with diagnostic-quality CTA were included. Studies were not excluded for trauma indications or prior pelvic surgery, ensuring an inclusive, real-world imaging population. CM presence, laterality, vessel diameter, and arterial origin were recorded. Demographic variables were collected, and analyses were performed using the Wilcoxon rank-sum test, paired t-test, and sign test. Arterial CM was identified in 318 of 988 patients (32.2%). Among CM-positive cases, 53% were unilateral and 47% bilateral, with laterality distributed as 25% right-sided, 27% left-sided, and 47% bilateral. The median vessel diameter measured 2.40 mm (IQR, 2.00-2.50 mm). Most CMs originated from the inferior epigastric artery (98%), while 2.3% arose directly from the external iliac artery. CM was more common in females and in non-Hispanic Black individuals. Patients with CM were significantly older than those without (p = 0.035). Vessel diameter differed significantly between sexes (paired t-test, p = 0.004; sign test, p = 0.006). Across two major academic hospitals, this large consecutive CTA cohort-the largest reported to date-identified arterial CM in nearly one-third of patients and demonstrated meaningful demographic variability. Given its potential for clinically significant bleeding, systematic evaluation of CM on preoperative or preprocedural CTA may help reduce iatrogenic vascular injury during pelvic and acetabular surgery.