What are the branches of the external iliac artery?

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Branches of the External Iliac Artery

The external iliac artery has two main branches: the inferior epigastric artery and the deep circumflex iliac artery (DCIA). 1

Anatomical Definition and Course

The external iliac artery is defined as the terminal branch of the common iliac artery that extends from the origin of the internal iliac artery to the inferior epigastric artery. 1 At the level of the inferior epigastric artery origin, the external iliac artery becomes the common femoral artery as it passes beneath the inguinal ligament. 1

Primary Branches

Inferior Epigastric Artery

  • This vessel marks the distal termination point of the external iliac artery. 1
  • The inferior epigastric artery serves as the anatomic landmark where the external iliac artery transitions to become the common femoral artery. 1
  • This artery is the primary blood supply for the deep inferior epigastric perforator (DIEP) flap used in breast reconstruction surgery. 1

Deep Circumflex Iliac Artery (DCIA)

  • The DCIA branches laterally from the external iliac artery, directly opposite the origin of the inferior epigastric artery. 2
  • It courses along the inguinal ligament, positioned directly behind the inguinal ligament in 98% of cases. 2
  • The DCIA originates approximately 7.28 ± 0.99 cm from the anterior superior iliac spine and 5.91 ± 1.03 cm from the pubic tubercle. 2
  • In 78% of cases, it bifurcates into horizontal and ascending branches; in 6% it trifurcates; and in 4% it exhibits multiple fine tree-like branching patterns. 2

Additional Small Branches

Branches to the Psoas Major Muscle

  • The external iliac artery gives off small branches to supply the psoas major muscle. 3
  • In 75% of cases, these are represented by a single large-caliber vessel, though they can be multiple and slender. 3
  • This principal artery to the psoas muscle may be responsible for the curves seen in the external iliac artery in aged individuals and certain competitive athletes. 3

Clinical Relevance

Understanding these branches is critical for:

  • Surgical planning in peripheral artery interventions, where the external iliac artery serves as a key anatomic segment in the aortoiliac system. 1
  • Preoperative imaging for breast reconstruction using DIEP flaps, where the deep inferior epigastric artery anatomy must be mapped. 1
  • Avoiding iatrogenic injury during pelvic and inguinal surgical procedures, particularly lymphadenectomy where the external iliac vessels serve as anatomic boundaries. 1

References

1
Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

3
Research

The principal artery of the psoas major muscle.

Surgical and radiologic anatomy : SRA, 1989

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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