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Both common iliac arteries are accompanied along their course by the two common iliac veins, which lie posteriorly and to the right. Their terminal bifurcation is crossed anteriorly by the ureters. [1] This is significant, as the bifurcation of the common iliac artery is the second point of ureteric constriction. [1]
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.
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]
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]
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.
In the legs, bypass grafting is used to treat peripheral vascular disease, acute limb ischemia, aneurysms and trauma.While there are many anatomical arrangements for vascular bypass grafts in the lower extremities depending on the location of the disease, the principle is the same: to restore blood flow to an area without normal flow.
The inferior suprarenal artery is a paired artery that supplies the adrenal gland. It usually originates at the trunk of the renal artery before its terminal division, but with many common variations. It supplies the adrenal gland parenchyma, the ureter, and the surrounding cellular tissue and muscles.
The ureters are tubular structures, approximately 20–30 cm (8–12 in) in adults, [1] that pass from the pelvis of each kidney into the bladder. From the renal pelvis, they descend on top of the psoas major muscle to reach the brim of the pelvis. Here, they cross in front of the common iliac arteries.