Common iliac arteries

Branch · L4 Iliac crest plane Divide L5–S1

Terminal branches of the aorta, formed at its bifurcation at L4 (a little below the umbilicus, in the plane of the iliac crests). Each runs down and laterally to divide in front of the sacroiliac joint at L5–S1 into the internal iliac (pelvis, perineum, gluteal region) and external iliac (lower limb, becoming the femoral artery beneath the inguinal ligament).

Traced from the start

  1. Abdominal aorta
  2. Common iliac arteries

Detail

Level
Aortic bifurcation L4; common iliac bifurcation at L5–S1 on the pelvic brim
Terminal branches
Internal iliac, external iliac
Relations
Ureter crosses the common iliac bifurcation in front; the left common iliac vein passes behind the right common iliac artery to form the IVC at L5

When it goes wrong

Aortoiliac atherosclerotic occlusion

Leriche syndrome: buttock and thigh claudication, absent femoral pulses and erectile dysfunction from loss of internal iliac flow

Right common iliac artery compressing the left common iliac vein against L5

May–Thurner syndrome: left leg deep vein thrombosis, typically in a young woman

Ureteric stone passing down the ureter

Commonly impacts at the pelvic brim where the ureter crosses the common iliac bifurcation, one of the three natural constrictions

Practise this structure

1 question in the bank tagged Arterial Supply.