[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Anatomy](https://durgical.com/en/anatomy/) › [Lower limb](https://durgical.com/en/anatomy/region/lower-limb/) › External iliac artery [Cardiovascular system](https://durgical.com/en/anatomy/system/cardiovascular-system/) · [Lower limb](https://durgical.com/en/anatomy/region/lower-limb/) # External iliac artery The external iliac artery is the main artery to the leg inside the [pelvis](https://durgical.com/en/anatomy/region/pelvis/); it becomes the femoral artery at the groin. [See in 3D →](https://durgical.app/?from=durgipedia&lang=en#region=lower_limb&select=external_iliac_artery&side=r) Opens in the Durgical app, no sign-up needed. ## What it is A large artery inside the pelvis, branching from the [common iliac artery](https://durgical.com/en/anatomy/common-iliac-artery/) and running along the psoas muscle. ## What it does Carries blood to the leg. It becomes the femoral artery as it passes under the inguinal ligament. ## Key points - Its inferior epigastric branch marks the deep inguinal ring: indirect inguinal hernias pass lateral to it, direct hernias medial to it, through Hesselbach's triangle - The ureter crosses the iliac vessels at the pelvic brim, near the start of the external iliac artery, a landmark in pelvic surgery - [Kidney](https://durgical.com/en/anatomy/kidney/) transplants are usually placed in the iliac fossa, with the donor [renal artery](https://durgical.com/en/anatomy/renal-artery/) joined to the external iliac artery ## Key facts **Origin** Common iliac artery at level of sacroiliac joint (pelvic brim) **Branches** Inferior epigastric, deep circumflex iliac **Supplies** [Lower limb](https://durgical.com/en/anatomy/region/lower-limb/); lower anterior abdominal wall via branches; becomes femoral behind inguinal ligament ## Relations **Course** From the common iliac bifurcation in front of the [sacroiliac joint](https://durgical.com/en/anatomy/sacroiliac-joint/) it runs down and forward along the pelvic brim and passes behind the [inguinal ligament](https://durgical.com/en/anatomy/inguinal-ligament/) at the mid-inguinal point to become the [femoral artery](https://durgical.com/en/anatomy/femoral-artery/) **Lateral** The [psoas major](https://durgical.com/en/anatomy/psoas-major/), with the [genitofemoral nerve](https://durgical.com/en/anatomy/genitofemoral-nerve/) on it **Medial** The [external iliac vein](https://durgical.com/en/anatomy/external-iliac-vein/), medial to it at the inguinal ligament and partly behind it higher up; the external iliac lymph nodes around both **In front** [Peritoneum](https://durgical.com/en/anatomy/peritoneum/); crossed by the [ureter](https://durgical.com/en/anatomy/ureter/) near its origin, by the gonadal vessels and, near the deep ring, by the [ductus deferens](https://durgical.com/en/anatomy/ductus-deferens/) (or round ligament); the [ileum](https://durgical.com/en/anatomy/ileum/) on the right, the [sigmoid colon](https://durgical.com/en/anatomy/sigmoid-colon/) on the left ## How to find it Not felt. Its surface line runs from about 2 cm below and slightly left of the umbilicus (the aortic bifurcation, about L4) to the mid-inguinal point: the upper third of this line marks the common iliac artery and the lower two-thirds the external iliac artery. ## On imaging CT angiography is the standard to map stenosis, occlusion or aneurysm from the iliac bifurcation to the inguinal ligament; MR angiography is an alternative. Duplex ultrasound sees it through the [abdomen](https://durgical.com/en/anatomy/region/abdomen/) and shows stenosis as high velocity. It is a key access route for endovascular repair, so its calibre and calcium are checked on CT first. Radiographs only show calcified walls. ## Common problems - Narrowing from plaque (peripheral artery disease) can cause leg or buttock pain when walking. ## Clinical notes - A femoral puncture made too high enters the external iliac artery: bleeding then tracks into the retroperitoneum, cannot be compressed and may show only as falling blood pressure or flank and back pain - Aortoiliac occlusive disease (Leriche syndrome): buttock and thigh claudication, weak or absent femoral pulses and erectile dysfunction - Route for iliac angioplasty and stents and for large-bore delivery systems such as those for aortic stent grafts and heart valves - Its deep circumflex iliac branch runs behind the inguinal ligament to the anterior superior iliac [spine](https://durgical.com/en/anatomy/region/spine/) and then along the inner lip of the iliac crest; it is the pedicle of the vascularised iliac crest flap, and its ascending branch can bleed at lateral laparoscopic ports ## Anatomical variants - Agenesis (rare): the [internal iliac artery](https://durgical.com/en/anatomy/internal-iliac-artery/) then continues into the thigh and takes over the supply of the leg - Marked coiling or tortuosity (rare), which matters in catheter procedures - Its inferior epigastric branch may give rise to the [obturator artery](https://durgical.com/en/anatomy/obturator-artery/) (an aberrant obturator artery) ## Development The early lower limb bud is fed by an axial artery that runs with the [sciatic nerve](https://durgical.com/en/anatomy/sciatic-nerve/) and comes from the internal iliac side. The external iliac and femoral arteries grow later and take over; when the axial vessel survives into adult life it is called a persistent sciatic artery. ## Related conditions - [Acute limb ischaemia](https://durgical.com/en/conditions/acute-limb-ischaemia/) ## Test yourself Think of the answer, then tap the question to see it. ## Where does the external iliac artery become the femoral artery? Behind the inguinal ligament, at the mid-inguinal point. ## Which branch of the external iliac artery separates indirect from direct inguinal hernias? The inferior epigastric artery: indirect hernias pass lateral to it, direct hernias medial to it through Hesselbach's triangle. ## Why is a femoral puncture made too high dangerous? It enters the external iliac artery: bleeding tracks into the retroperitoneum, cannot be compressed and may show only as falling blood pressure or flank pain. ## Which artery is the donor renal artery usually joined to in a kidney transplant? The external iliac artery, with the kidney placed in the iliac fossa. [Add to my cards (4)](https://durgical.app/estudiar/?add=/en/anatomy/external-iliac-artery/) Educational information, not medical advice. For any symptom, see a health professional. ## Its names **Official Latin (TA2)** arteria iliaca externa TA2 4357 **Official Spanish (DeCS)** Arteria ilíaca externa DeCS D007083 **English (TA2)** External iliac artery **Also called** arteria ilica externa ## Related - [Psoas major](https://durgical.com/en/anatomy/psoas-major/) - [Femoral artery](https://durgical.com/en/anatomy/femoral-artery/) - [External iliac vein](https://durgical.com/en/anatomy/external-iliac-vein/) - [Iliacus](https://durgical.com/en/anatomy/iliacus-muscle/) Sources: Terminologia Anatomica (TA2); [DeCS](https://decs.bvsalud.org/es/ths/resource/?id=7266&filter=ths_termall&q=Arteria%20Il%C3%ADaca); [Anatomy, Abdomen and Pelvis: External Iliac Arteries](https://www.ncbi.nlm.nih.gov/books/NBK519552/); Tratado de anatomía humana (9.ª ed.), tomo II, Angiología: aorta descendente, arterias ilíacas y arterias del miembro inferior. ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/anatomy/external-iliac-artery/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/external-iliac-artery/