Author(s): Goel R.R.; Muralidharan V.; Goel M.; Al-Islam S.; Gavan D.; Salaman R.; Al-Khaffaf H.
Source: European Surgical Research; Sep 2017; vol. 58 ; p. 34
Publication Date: Sep 2017
Publication Type(s): Conference Abstract
Abstract:Background: Isolated Internal iliac artery aneurysms (IIA) are rare (0.3%-0.5%). Identified incidentally on radiological studies or presenting as rupture (33%), with high mortatilty (33-50%). Materials and Methods: A 42 year old man with the history of Takayasu's disease and thoraco-abdominal aortic aneurysm repair, presented with pain, weakness, and numbness in the right leg of two weeks duration. His magnetic resonance scan, suggested right psoas abscess causing neurological symptoms. Ultrasound guided drainage was suggested. Ultrasound demonstrated aneurysmal flow. Subsequent computerised tomography angiography revealed a ruptured right internal iliac artery aneurysm into the right psoas muscle. Patient proceeded to have an urgent angiogram. A covered stent was placed in right common iliac artery which occluded the rupture. Usual clinical presentation of IIA are abdominal pain, back pain, hydronephrosis, renal failure, haematuria, shock due to free rupture. IIAAs are more common on the left (61.8% left, 27.3% right, 10.9% bilateral). Treatment options are open, endovascular or hybrid repair. Results: The post-operative period was complicated by pancreatitis. His right leg weakness did not worsen clinically. He is having outpatient physiotherapy and neurology follow-up. Conclusion: Endovascular means can effectively manage ruptured IIA. Due to low incidence and only accounting for ten percent of all iliac aneurysms with varying presentations, knowledge and management of internal iliac aneurysm is important. With the advent of novel techniques early means of diagnosis and management of IIA requires further research.
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