Iliac Artery

What are the iliac arteries?

The iliac arteries are blood vessels that provide blood to the legs, pelvis, reproductive organs and other organs in the pelvic area. The pelvis is the lower part of your torso, just above where your legs connect at the hips. The iliac arteries branch off of the bottom of the aorta, the large artery coming out of the top of the heart.

The iliac arteries are peripheral arteries. Peripheral means they provide blood to parts of the body farther away from the heart.

What problems affect the iliac arteries?

Like many blood vessels, the iliac arteries are prone to a buildup of fat and cholesterol (plaque). This plaque can affect blood flow and cause peripheral artery disease (PAD). PAD causes leg pain that makes walking difficult.

What is the purpose of the iliac arteries?

As part of the body’s circulatory system, the iliac arteries carry blood to the:

• Back and stomach muscles.
• Lower extremities (legs, feet, hips, butt and thighs).
• Male reproductive system or female reproductive system.
• Other pelvic organs, including the bladder, intestines, liver and pancreas.

Where are the iliac arteries?

You have two iliac arteries: one on the right side of the body (called the right common iliac artery) and one on the left (called the left common iliac artery).

Both common iliac arteries branch from the base of the aorta. This part of the aorta is called the abdominal aorta because it’s in your belly. The common iliac arteries begin around the midsection or belly button region.

What are the iliac artery branches?

From the aorta, each common iliac artery travels down about 1 inch (3 centimeters) before it divides. There, it splits into an internal iliac artery and external iliac artery. These smaller channels of the iliac arteries divide into even smaller arteries to reach more of your lower body.

What are the external iliac arteries?

The external iliac arteries are the largest of the common iliac branches. The external iliac arteries become femoral arteries in the legs. These large blood vessels are the main source of blood to the legs and feet.

The two branches of external iliac arteries include the:

• Deep circumflex arteries: Provide blood to the stomach’s oblique and transverse abdominus muscles (core muscles).
• Inferior epigastric arteries: Provide blood to the rectus abdominus muscle (the six-pack muscles that run vertically on each side of the stomach).

What are the internal iliac arteries?

The internal iliac arteries divide into nine anterior (front) arteries and three posterior (rear) arteries. Two of the anterior iliac arteries are only present in the umbilical cord in pregnant people.

These arteries send blood to:

• Back muscles.
• Pelvic floor and organs.
• Rectum.
• Reproductive organs.
• Thighs, hips and rear.

What conditions and disorders affect the iliac arteries?

Conditions that affect the iliac arteries include:

• Atherosclerosis: Fat and cholesterol deposits (plaque) collect inside the artery walls, narrowing arteries and slowing blood flow.
• PAD: Atherosclerosis in the iliac arteries can decrease blood flow to the feet and legs, making it painful to walk depending on the amount of plaque. PAD increases your risk of stroke, heart attack and amputation. PAD affects approximately 10 million Americans, most of them over age 65.
• Iliac artery stenosis: Some people have a rare blood vessel disease called fibromuscular dysplasia (FMD) that causes iliac artery stenosis. The iliac arteries become stiff and narrow. They are prone to tears (dissections) and aneurysms (weak, bulging spots in the artery wall).
• May-Thurner syndrome: Also called iliac vein compression syndrome, this problem occurs when the right common iliac artery presses the left common iliac artery against the spine. The condition increases your risk of deep vein thrombosis (DVT), a blood clot in the leg.

How can I protect my iliac arteries?

These lifestyle changes can keep the iliac arteries healthy and lower your risk of PAD:

• Be physically active most days of the week.
• Eat a heart-healthy diet that’s low in fat, cholesterol and salt.
• Find healthy ways to manage stress, like meditation or going for a walk with a friend.
• Maintain a healthy weight.
• Manage conditions like diabetes, high blood pressure and high cholesterol.
• Quit smoking.

When should I talk to a doctor?

You should call your healthcare provider if you experience:

• Difficulty walking.
• Nonhealing leg or foot wounds.
• Pain when walking or sleeping.

A note from Cleveland Clinic

If you’re at risk for PAD or other iliac artery problems, you should see your healthcare providers if walking becomes painful. Also check with a provider if you develop nonhealing foot sores. Leg pain doesn’t always mean you have PAD. Simple, noninvasive tests can measure blood flow through the legs and help your provider make an accurate diagnosis. You can make diet and lifestyle changes to keep the iliac arteries open and healthy.