Simplifying the internal iliac artery aneurysm

Isolated aneurysms of the internal iliac (hypogastric) artery are a rare va riant of aortoiliac aneurysm disease, with an incidence at around 0.04% of all aorto-iliac aneurysms. Because of their location deep within the pelvis , they may present late and are often large. The incidence of rupture is hi gh and may be up to 38% at initial presentation; furthermore, this has been reported to carry a 58% mortality rate. As such the early and aggressive m anagement of isolated internal iliac artery aneurysms (IIAAs) is mandatory to avoid the high morbidity and mortality associated with rupture. This art icle includes a literature review regarding IIAAs and outlines the current surgical and endovascular management options for this most rare and technic ally challenging of aneurysms.