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Vascular and Endovascular Surgery
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Ruptured Solitary Iliac Artery Aneurysms: A "Silent" Killer?

Report of Four Cases and Review of the Literature

Pavel J. Levy

Richland Memorial Hospital, USC Department of Surgery, Columbia

C. Alden Sweatman

Columbia Surgical Associates, Columbia, South Carolina

Daniel W. Davis

Columbia Surgical Associates, Columbia, South Carolina

Daniel S. Rush

Richland Memorial Hospital, USC Department of Surgery, Columbia

James L. Haynes

Richland Memorial Hospital, USC Department of Surgery, Columbia

Between 1982 and 1991, 38 cases of ruptured solitary iliac artery aneurysm (SIAA) were reported in the English literature. Iliac artery aneurysms are frequently found in conjunction with abdominal aortic aneurysm (AAA); however SIAA is a rare entity. Review of the literature and 4 new cases revealed a diversity of clinical presentation that may be partially explained by various mechanisms of SIAA rupture. Different from rupture of the AAA, symptoms of ruptured or leaking SIAA may be obscure and even present as a chronic disease. Emergent operative management is mandatory and requires endoaneurysmorrhaphy with interposition graft for the common and external iliac aneurysms or ligation of internal iliac aneurysms. The reported mortality of up to 75% reflects the delay in diagnosis, lack of operative experience with this particular entity, and frequent associated complications.

Vascular and Endovascular Surgery, Vol. 27, No. 8, 611-620 (1993)
DOI: 10.1177/153857449302700808
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