Iliac aneurysms

Iliac aneurysms are defined as localized dilations affecting all arterial layers, with a diameter exceeding by >50% the adjacent segment or the reference norms (which vary depending on the location). They are typically located on the common iliac arteries.

Etiologies

  See detailed article: Arterial aneurysms

Their causes are the same as for any arterial aneurysm, but atherosclerosis is the predominant cause.

Clinical Presentation

Most often asymptomatic, they may present with:

• Abdominal or sciatic-like pain due to compression of nearby nerve structures
• Acute ischemia of the lower limbs
• Rupture (rare)

Complications

  See detailed article: Arterial aneurysms

See detailed article: Acute Lower Limb Ischemia

The complications are similar to those of any arterial aneurysm, but thromboembolic complications (acute ischemia of the lower limbs) are the most common.

Management

Indications for treatment (prosthesis or endograft) are:

• Symptomatic (complicated) aneurysms
• Aneurysms with a diameter > 4 cm

In other cases, only annual ultrasound monitoring is required.

Possible etiological treatment, screening, and management of cardiovascular risk factors.

Bibliography

EMC, Traité d'Angéiologie, 2018

Kirkwood ML, Iliac artery aneurysm, UpToDate, 2024