Aneurysms of the internal iliac artery: Management strategy

With the widespread use of CT scans, detection and treatment of internal il iac artery aneurysms (IIA) have become more frequent. In the last few years , endovascular repair has been added to the therapeutic arsenal. We reviewe d the records of 38 patients treated for 44 IIA between 1987 and 1997 to as sess immediate and long-term outcome using various therapeutic methods. Ane urysms were divided into three groups according to the circumstances of tre atment. Group I included 25 IIA treated at the same time as abdominal aorti c aneurysm (AAA). The morbidity/ mortality rate in this group was comparabl e to that in patients who underwent isolated AAA repair. Group II included 14 IIA treated during follow-up of AAA repair. Most complications in this g roup were intraoperative. Group III included five isolated IIA not associat ed with AAA repair. Complications were similar to those in group I. On the basis of this retrospective analysis, we propose a management strategy in w hich open surgery, endovascular repair, or both are used, depending on the circumstances of treatment.