Common iliac artery

At a glance

English

Common iliac artery

Latin (TA2)

Arteria iliaca communis

System

Artery

Region

Trunk

Side

Paired, left and right

About the common iliac artery

The abdominal aorta ends at about the level of the fourth lumbar vertebra, a little left of the midline, by splitting into the right and left common iliac arteries. Each is a short, wide vessel, roughly 4 cm long and over a centimetre across in adults, and it carries the whole arterial supply for one side of the pelvis and one lower limb.

From the aortic bifurcation each artery runs downwards and outwards along the medial edge of psoas major. It ends over the sacroiliac joint at the level of the pelvic brim, dividing into the external iliac artery, which heads for the thigh, and the internal iliac artery, which drops into the pelvis. The common iliac artery itself normally gives no named branches apart from small twigs to the peritoneum, psoas, ureter and nearby tissues.

Its relations differ a little on the two sides. The common iliac veins lie behind and to the right of the arteries; because the inferior vena cava begins on the right, the left common iliac vein crosses behind the right common iliac artery, where it can be compressed. The right artery is a little longer than the left. At the point of division each artery is crossed in front by the ureter, one of the places where a kidney stone tends to lodge. The sympathetic trunk and lymph nodes of the common iliac group also lie close by.

Atherosclerosis often narrows the vessels at or just below the aortic bifurcation, giving buttock and thigh pain on walking; balloon angioplasty, stents or bypass grafts are used to treat it. The arteries may also widen into aneurysms, often together with an abdominal aortic aneurysm, and these are repaired with stent grafts or open surgery. Compression of the left common iliac vein by the right artery is known as May–Thurner syndrome and predisposes to deep vein thrombosis in the left leg.

Course and supply

Arises from

Arises from the bifurcation of the abdominal aorta at about the level of the fourth lumbar vertebra.

Ends in

Ends over the front of the sacroiliac joint, at the pelvic brim, by splitting into internal and external iliac arteries.

Supplies

Carries the arterial supply for one side of the pelvis, the gluteal region and the whole lower limb; its own small twigs supply psoas, the ureter and the peritoneum.