Isolated iliac artery aneurysms in patients with or without previous abdominal aortic aneurysm repair

BACKGROUND: Isolated iliac artery aneurysms (IAA) in patients with or witho ut previous abdominal aortic aneurysm (AAA) repair are rare. We wanted to c ompare the presentation, distribution, treatment, outcome and patterns of s ubsequent aneurysm formation in these patients. METHODS: We retrospectively reviewed patients with isolated IAA over a 10-y ear period. Patients with primary isolated IAA (group 1) were compared with patients who presented with IAA after previous AAA repair (group 2). RESULTS: There were 23 patients in each group. Demographics and comorbiditi es were similar. No aneurysms were detected outside of the iliac system in group 1; 22% of patients in group 2 had other aneurysms. The mean time afte r AAA repair to IAA diagnosis was 8.8 +/- 3.2 years for operated on patient s. The in-hospital mortality was 0% for elective cases and 50% for emergenc y cases for both groups. Three patients in group 2 (13%) developed new aneu rysms during follow-up, whereas the only new aneurysm in group 1 was a cont ralateral IAA. CONCLUSIONS: Patients with new IAA after AAA repair have a greater tendency to develop further aneurysms in other sites, synchronously or metachronous ly. The time to detection of new IAA after AAA repair is at least 5 years i n most cases. In both groups, a quarter to a third of patients present with rupture, with a resultant mortality of 30% to 50%, whereas those operated on electively have minimal morbidity and almost no mortality. Am J Surg. 19 99;178:129-132. (C) 1999 by Excerpta Medica, Inc.