Purpose: Since isolated common iliac artery aneurysms are rare and the
re is no consensus regarding some aspects of their management, we revi
ewed our recorded experience with common iliac artery aneurysms from 1
977 through 1993. Methods: We were able to identify 25 patients having
a total of 33 common iliac artery aneurysms on the basis of informati
on maintained by our medical records staff, old surgical logs and a de
partmental registry that was implemented in 1989. Follow-up data were
collected from outpatient charts and by telephone contact. New imaging
studies were obtained for 14 patients who either underwent common ili
ac artery aneurysm repair without aortic replacement (aortic ultrasoun
d scans, n = 7) or had no surgical treatment whatsoever (computerized
tomography of the abdomen and pelvis, n = 7), Results: All 25 patients
were men (mean age, 71 years). Eighteen patients (72%) had elective (
n = 14) or urgent (n = 4) operations to repair common iliac artery ane
urysms with mean diameters of 3.8 cm and 5.8 cm, respectively. There w
as one postoperative death (5.5%) in conjunction with complementary re
nal revascularization in a patient with preoperative renal insufficien
cy. During a mean follow-up period of 50 months, two (29%) of the seve
n patients who had not received bifurcation grafts at the time of thei
r common iliac artery aneurysm procedures had developed infrarenal aor
tic aneurysms. Seven (28%) of the original 25 patients were observed w
ithout intervention for common iliac artery aneurysms measuring 2-2.5
cm in diameter. No common iliac artery aneurysm enlargement or new aor
tic aneurysms have been documented in any of these patients at a mean
follow-up interval of 57 months, Conclusions: In our limited experienc
e, the risk for spontaneous rupture appears to be concentrated among c
ommon iliac artery aneurysms exceeding 5 cm in diameter, while those t
hat are less than 3 cm in diameter may fail even to enlarge under obse
rvation. Therefore, common iliac artery aneurysms measuring greater th
an or equal to 3 cm in size probably warrant surgical treatment, at wh
ich time simultaneous aortic replacement also should be a serious cons
ideration. (C) 1998 The International Society for Cardiovascular Surge
ry. Published by Elsevier Science Ltd. All rights reserved.