Illustrated Encyclopedia of Human Anatomic Variation: Opus II: Cardiovascular System: Arteries: Pelvis
Ronald A. Bergman, PhD
Adel K. Afifi, MD, MS
Ryosuke Miyauchi, MD
Peer Review Status: Internally Peer Reviewed
The bifurcation of the common iliacs varies. In 68% of individuals studied, the division occurs between the fifth lumbar vertebra and the upper border of the sacrum. Approximately 12% occur above the fifth vertebra and 17% below the upper border of the sacrum. More frequently, the left common iliac artery divides further distally than the right.
The common iliacs may be absent; the external and internal iliacs then arise together from the distal end of the aorta.
Either artery may provide a large branch, such as the iliolumbar or the lateral sacral or middle sacral, sometimes a lumbar, or occasionally an "accessory" renal or a gonadal artery. In some cases, the right and left common iliacs are joined by a transverse anastomotic vessel.
The embryonic axis (ischiadic or sciatic) artery may persist and be of significant size and importance to give rise to the popliteal artery.
Occasionally the common iliac fails to to bifurcate, sinking into the true pelvis to provide the usual pelvic branches and then emerging to continue as the external iliac.
Unusual branches of the common iliac include a middle colic, umbilical, obturator, and the circumflex iliac.
The absence of the common iliac artery was noted on the left side of a dissected body by Walsham (he also noted that horses do not have common iliac arteries). The aorta , in the case of Walsham's subject, divided into three branches opposite the middle of the fourth lumbar vertebra - into a right common iliac, a left external, and a left internal iliac. Cruveilhier reported one instance of the absence of the right common iliac artery.
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