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External Iliac Vein

vena iliaca externa

The external iliac vein is the continuation of the femoral vein above the inguinal ligament, running medial to the external iliac artery along the pelvic brim to the sacroiliac joint where it joins the internal iliac vein to form the common iliac vein. It receives the inferior epigastric and deep circumflex iliac veins. It is the primary venous conduit of the lower limb within the pelvis.

Region: Pelvis & Hip

Clinical Relevance

Clinical Notes

The external iliac vein is the primary site for laparoscopic and open access to the iliac vessels in renal transplantation, where the donor renal vein is anastomosed end-to-side to the external iliac vein in the right iliac fossa. It is also the venous outflow for ilio-femoral bypass surgery and for iliac vein stenting in May-Thurner syndrome (compression of the left common iliac vein by the right common iliac artery). DVT at this level requires anticoagulation and may be amenable to catheter-directed thrombolysis for iliofemoral DVT with high clot burden.

Pathology

Common Injuries & Conditions

External Iliac Vein Injury in Renal Transplant

Renal transplant anastomosis of the donor renal vein to the recipient external iliac vein is the standard venous outflow technique; inadvertent twisting or kinking of the anastomosis produces early graft thrombosis managed by immediate surgical revision with thrombectomy and re-anastomosis.