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Common and External Iliac Arteries

Q: Which muscles are supplied by the deep circumflex iliac artery?

The deep circumflex iliac artery (a. circumflexa ilium profunda) supplies the muscles of the anterolateral abdominal wall and pelvis. Muscles supplied by this artery include: Transversus abdominis muscle (m. transversus abdominis) — the artery runs between it and the internal oblique muscle.Internal oblique abdominal muscle (m. obliquus internus abdominis) — receives branches along the course of the vessel near the iliac crest.Iliacus muscle (m. iliacus) — supplied within the iliac fossa. The artery also sends branches to the iliac bone itself.

Q: How is the external iliac vein positioned relative to the external iliac artery within the vascular lacuna?

Within the vascular lacuna, the external iliac vein (v. iliaca externa) lies medial to the external iliac artery (a. iliaca externa). Passing inferior to the inguinal ligament through the vascular lacuna (lacuna vasorum), the femoral vein lies medial to the artery and directly continues as the external iliac vein. Throughout its course, the external iliac vein mirrors the path of the artery, maintaining a medial position until it merges with the internal iliac vein.

Arteriae iliacae communis et externa

For medical students2 min readUpdated 2026-10-10

The common iliac artery is a major paired blood vessel arising from the bifurcation of the abdominal aorta. After sending small branches to nearby tissues, it divides into the external and internal iliac arteries, providing the primary arterial blood supply to the pelvic organs, abdominal wall, and lower extremity.

OriginArises at the level of the L4 vertebra (aortic bifurcation)

ContinuationThe external iliac artery continues as the femoral artery

Corona mortisA hazardous anastomosis of the pubic branch near the pubic symphysis

LengthThe common iliac artery is approximately 5–7 cm long

Common Iliac Artery

The paired common iliac artery (a. iliaca communis) originates from the bifurcation of the abdominal aorta. This division occurs strictly at the level of the IV lumbar vertebra (L4).

From its origin, the vessel runs inferiorly and laterally, reaching the region of the sacroiliac joint. The average length of this segment is 5 to 7 centimeters. Throughout its course, the artery gives off several small branches that supply:

Pelvic and abdominal lymph nodes;
The ureter;
The psoas major muscle (m. psoas major).

At the sacroiliac articulation, the common iliac artery bifurcates into two major trunks: the external iliac (a. iliaca externa) and internal iliac (a. iliaca interna) arteries.

Topography of the External Iliac Artery

The external iliac artery (a. iliaca externa) is the direct continuation of the common iliac artery. Its main course runs along the medial border of the psoas major muscle (m. psoas major).

Upon reaching the inguinal ligament, the artery passes deep to it through the vascular lacuna (lacuna vasorum). Immediately after crossing this anatomical landmark, it changes its name and continues as the femoral artery (a. femoralis), heading toward the structures of the lower limb.

Branches of the External Iliac Artery

Before exiting to the thigh, the external iliac artery gives off two important branches that supply the anterior abdominal wall and adjacent structures.

1. Inferior epigastric artery (a. epigastrica inferior) It arises from the main trunk just superior to the inguinal ligament. The vessel ascends superiorly along the posterior surface of the anterior abdominal wall and enters the rectus sheath (vagina m. recti abdominis).

Anastomoses: Forms a crucial collateral pathway by anastomosing with the superior epigastric artery (a. epigastrica superior), which is a branch of the internal thoracic artery.
Pubic branch (r. pubicus): Runs toward the pubic symphysis. It frequently forms an anastomosis with the obturator artery—a vascular connection historically known as the corona mortis ("crown of death") due to the risk of fatal hemorrhage during pelvic surgery.
Branches to genital structures: In males, it gives off the cremasteric artery (a. cremasterica); in females, the artery of the round ligament of the uterus (a. lig. teretis uteri). These pass through the superficial inguinal ring. In males, the vessel anastomoses with the testicular artery (a. testicularis); in females, with uterine branches.

2. Deep circumflex iliac artery (a. circumflexa ilium profunda) This branch courses laterally, running parallel to the inguinal ligament. It then ascends along the iliac crest, situated within the muscular layer between the internal oblique and transversus abdominis muscles.

Anastomoses: Connects with branches of the iliolumbar artery (a. iliolumbalis) and lumbar arteries (aa. lumbales).

Mnemonic

The level of origin of the common iliac arteries is easily remembered by the number 4: aortic bifurcation occurs at the level of the 4th lumbar vertebra (L4).

Frequently asked questions

In which peritoneal fold does the inferior epigastric artery run on the internal surface of the anterior abdominal wall?

The inferior epigastric artery runs within the lateral umbilical fold (plica umbilicalis lateralis). This fold is paired and located on the inner surface of the anterior abdominal wall overlying the inferior epigastric vessels (a. et v. epigastricae inferiores). It is the only fold in this region that contains functional blood vessels.

Which muscles are supplied by the deep circumflex iliac artery?

The deep circumflex iliac artery (a. circumflexa ilium profunda) supplies the muscles of the anterolateral abdominal wall and pelvis.

Muscles supplied by this artery include:

Transversus abdominis muscle (m. transversus abdominis) — the artery runs between it and the internal oblique muscle.
Internal oblique abdominal muscle (m. obliquus internus abdominis) — receives branches along the course of the vessel near the iliac crest.
Iliacus muscle (m. iliacus) — supplied within the iliac fossa.

The artery also sends branches to the iliac bone itself.

How is the external iliac vein positioned relative to the external iliac artery within the vascular lacuna?

Within the vascular lacuna, the external iliac vein (v. iliaca externa) lies medial to the external iliac artery (a. iliaca externa).

Passing inferior to the inguinal ligament through the vascular lacuna (lacuna vasorum), the femoral vein lies medial to the artery and directly continues as the external iliac vein. Throughout its course, the external iliac vein mirrors the path of the artery, maintaining a medial position until it merges with the internal iliac vein.

Where does the external iliac artery become the femoral artery?

The transition occurs as the artery passes deep to the inguinal ligament through the vascular lacuna.

With which artery does the inferior epigastric artery anastomose within the rectus abdominis muscle?

It forms a prominent anastomosis with the superior epigastric artery, establishing an important collateral blood flow pathway.

What is the corona mortis?

It is an anastomotic vascular connection between the pubic branch of the inferior epigastric artery and the obturator artery near the pubic symphysis.

Go deeper

Boundaries and contents of the vascular lacuna
Internal iliac artery: parietal and visceral branches
Collateral circulation of the anterior abdominal wall
Topography of the rectus sheath