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The common iliac artery is a large artery of the abdomen paired on each side. It originates from the aortic bifurcation at the level of the 4th lumbar vertebra . It ends in front of the sacroiliac joint , one on either side, and each bifurcates into the external and internal iliac arteries .
The abdominal aneurysm extends down to the common iliac arteries in about 25%-30% of patients. In such cases, the iliac limbs can be extended into the external iliac artery to bypass a common iliac aneurysm. Alternatively, a specially designed endograft, (an iliac branch device) can be used to preserve flow to the internal iliac arteries.
Angiography provides important information regarding the perfusion and patency of distal arteries (e.g. femoral artery). The presence of collateral arteries in the pelvic and groin area is important in maintaining crucial blood flow and lower limb viability. However, angiography should only be used if symptoms warrant surgical intervention. [2]
Because of its similarities to deep vein thrombosis (DVT), May–Thurner syndrome is rarely diagnosed amongst the general population. In this condition, the right iliac artery sequesters and compresses the left common iliac vein against the lumbar section of the spine, [5] resulting in swelling of the legs and ankles, pain, tingling, and/or numbness in the legs and feet. [6]
The aortic bifurcation is the point at which the abdominal aorta bifurcates (forks) into the left and right common iliac arteries. The aortic bifurcation is usually seen at the level of L4, [1] just above the junction of the left and right common iliac veins. The right common iliac artery passes in front of the left common iliac vein.
The lengths of the common iliac and internal iliac arteries bear an inverse proportion to each other, the internal iliac artery being long when the common iliac is short, and vice versa. The place of division of the internal iliac artery varies between the upper margin of the sacrum and the upper border of the greater sciatic foramen.
An aneurysm is usually defined as an outer aortic diameter over 3 cm (normal diameter of the aorta is around 2 cm), [17] or more than 50% of normal diameter that of a healthy individual of the same sex and age. [9] [18] If the outer diameter exceeds 5.5 cm, the aneurysm is considered to be large. [16] The common iliac artery is classified as: [19]
Acute limb ischaemia (ALI) occurs when there is a sudden lack of blood flow to a limb [1] within 14 days of symptoms onset. [2] On the other hand, when the symptoms exceed 14 days, [3] it is called critical limb ischemia (CLI).
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