Iliac Aneurysm

Incidence

• In conjunction with AAA (Isolated iliac aneurysms unusual – usually CIA/IIA not EIA)

Clinical

• Most are asymptomatic & incidental
• May present with symptoms related to compression / erosion of surrounding structures
• Obstructive uropathy - ureteral obstruction / neuropathy / unilateral leg swelling - adjacent iliac vein
• Symptomatic aneurysms / > 4cm may be palpable on abdominal or rectal exam

Management

• Diameter ≥3 cm→ Repair if pt fit
  • Repair aims to preserve flow to pelvis through at least one Internal Iliac Artery to prevent buttock claudication / impotence and maintain perfusion to the distal colon
• Open vs endovascular repair
  • Endovascular repair preferred
  • Open repair of isolated iliac arteries can be done though a retroperitoneal approach