AB037. SOH22ABS124. Isolated internal iliac artery aneurysm: two case reports and systematic review
Vascular Session

AB037. SOH22ABS124. Isolated internal iliac artery aneurysm: two case reports and systematic review

Liga Akmenkalne, Baker Ghoneim, Adeel Syed, Kenneth Thornton, Sinead Cremen, Sean O’Neill, Adrian O’Callaghan, Catriona Canning, Mary Paula Colgan, Zenia Martin, Prakash Madhavan

Department of Vascular Surgery, St. James’s Hospital, Dublin, Ireland

Background: Isolated internal iliac artery aneurysms (IIAAs) are rare and their optimal treatment strategy is not well established.

Methods: We present two cases of IIAAs along with a systemic review.

Results: The first case presents an incidental finding of an isolated 6.8×4.8×4.6 cm IIAA. Treatment was by an endovascular approach with an Amplatzer-Plug inserted in the proximal neck of the IIAA and a stent-graft insertion from the proximal common iliac artery to the external iliac artery (EIA). In the second case, pre-operative angiography revealed recurrence of a ureteric-IIA fistula and persistent flow in a previously embolized IIAA. A stent-graft limb was used to exclude the IIA. A total of 303 publications were identified, with 78 included in the final review. Duplicate reports, and reports that described patients with concomitant AAA’s, infected or traumatic aneurysms or children were all excluded. In total 162 patients (175 IIAAs) were identified. Abdominal pain was the most common presentation (31 cases) followed by urological symptoms (24 cases). Rupture was reported in 44 cases (27%) with a mean aneurysm diameter at rupture of 7.5 cm. Fifty-seven cases had open surgery, while 36 cases had embolization and coverage with a stent. Death was reported in 18 cases. Four deaths were pre-operative. The remaining 14 were during or after open repair. There were no deaths after endovascular repair.

Conclusions: The management of IIAA’s remains challenging due to their rarity, their often insidious presentation and the difficulties associated with their anatomical exposure. Endovascular treatment with coiling and a stent-graft is a safe and effective treatment method.

Keywords: Aneurysm rupture; endovascular repair; internal iliac artery aneurysm; hypogastric artery aneurysm; systematic review

Acknowledgments

Funding: None.

Footnote

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-22-ab037
Cite this abstract as: Akmenkalne L, Ghoneim B, Syed A, Thornton K, Cremen S, O’Neill S, O’Callaghan A, Canning C, Colgan MP, Martin Z, Madhavan P. AB037. SOH22ABS124. Isolated internal iliac artery aneurysm: two case reports and systematic review. Mesentery Peritoneum 2022;6:AB037.

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