Continuing expansion of internal iliac artery aneurysms after surgical exclusion of the inflow - A report of two cases

Two patients with continuing expansion of an internal iliac artery aneurysm following earlier repair of an aortoiliac aneurysm are described. At the p rimary operation, inflow to small internal iliac aneurysms had been interru pted by simple proximal ligation only. During follow-up, however, increasin g diameter of the by CT-angiography completely thrombosed internal iliac an eurysms required re-operation. The observation of continuing growth of thro mbosed internal iliac artery aneurysms following proximal ligation emphasis es the danger of persistent collateral circulation and supports the concept of endotension in the absence of endoleak following endovascular AAA repai r.