Natural history and growth rates of isolated common iliac artery aneurysms

Steenberge, Sean P.; Caputo, Francis J.; Rowse, Jarrad W.; Lyden, Sean P.; Quatromoni, Jon G.; Kirksey, Levester; Smolock, Christopher J.

doi:10.1016/j.jvs.2022.01.022

Cited by 15 publications

(10 citation statements)

References 11 publications

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“…Therefore, current recommendations suggest that intervention should be considered for iliac aneurysms > 3.0 cm and all symptomatic aneurysms(28, 29). Some studies have also suggested a cut-off point of 3.5 cm for intervention (27,30). In our group, no rupture was reported in the AAD patients with IIAs(n = 7).…”

Section: Discussionmentioning

confidence: 48%

Prevalence of isolated iliac aneurysm in patients with acute aortic dissection: a five-year clinical retrospective study

Li,

Liu,

Wang

et al. 2024

Preprint

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Background The relationship between isolated iliac aneurysms (IIAs) and acute aortic dissection (AAD) is uncertain. We aimed to determine the prevalence of IIAs in patients with AAD and evaluate the independent risk factors for the presence of IIAs in them. Methods The aortic dissection group comprised seven patients with confirmed AAD and IIAs (AAD + IIA group) who had undergone computed tomography angiography (CTA). The control group comprised 597 patients with confirmed AAD without IIAs (AAD group). Basic clinical information of patients included in this study were completely obtained. Two readers reviewed all CTA scans independently to assess the data of the IIAs. Baseline characteristics were compared between the aortic dissection group and the control group using propensity score matching, and logistic regression analysis was performed to determine the independent risk factors for the presence of IIAs. Results The average patient age was 67.57 ± 10.13 years in the AAD + IIA group and 52.09 ± 12.06 years in the AAD group (P = 0.002). The proportion of smokers was respectively 85.7% and 39.6% in the AAD group and AAD + IIA group (P = 0.037). In the control group, no difference in age was observed between the dissections from the aorta to the iliac artery (n = 251 [42%]; 51.08 ± 11.35 years) and those limited to the aortic region (n = 346 [58%]; 52.82 ± 12.51 years) (P = 0.055). Multivariate analysis revealed age as an independent risk factor for the presence of IIAs (odds ratio, 1.144; 95% confidence interval, 1.059–1.235; P = 0.001). Similarly, smoking was an independent risk factor for the presence of IIAs (odds ratio, 14.601; 95% confidence interval, 1.601–129.073; P = 0.016). Conclusions The prevalence of IIA in AAD was 1.2%. Age and smoking can increase the prevalence of IIAs in patients with AAD. Further prospective studies are warranted to demonstrate the substantial prevalence of IIAs in the AAD population.

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Section: Discussionmentioning

confidence: 48%

Prevalence of isolated iliac aneurysm in patients with acute aortic dissection: a five-year clinical retrospective study

Li,

Liu,

Wang

et al. 2024

Preprint

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“…Studies suggest that IAAs constitute approximately 2%-6% of all abdominal arterial aneurysms[ 7 ]. Specifically, the common iliac artery is most commonly involved in approximately 70% of these aneurysms, while the IIA is involved in approximately 25% of case[ 8 ]. IAAs often coexist with other vascular abnormalities, especially abdominal aortic aneurysms.…”

Section: Discussionmentioning

confidence: 99%

Hematochezia due to rectal invasion by an internal iliac artery aneurysm: A case report

Li,

Zhao,

Liu

et al. 2024

World J Clin Cases

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BACKGROUND This case report presents the rare occurrence of hematochezia due to an internal iliac artery aneurysm leading to an arterioenteric fistula, expanding the differential diagnosis for gastrointestinal bleeding. It emphasizes the importance of considering vascular origins in cases of atypical hematochezia, particularly in the absence of common gastrointestinal causes, and highlights the role of imaging and multidisciplinary management in diagnosing and treating such unusual presentations. CASE SUMMARY A 75-year-old man with a history of hypertension presented with 12 d of hematochezia, experiencing bloody stools 7-8 times per day. Initial computed tomography (CT) scans revealed an aneurysmal rupture near the right internal iliac artery with suspected hematoma development. Hemoglobin levels progressively decreased to 7 g/dL. Emergency arterial angiography and iliac artery-covered stent placement were performed, followed by balloon angioplasty. Despite initial stabilization, minor rectal bleeding and abdominal pain persisted, leading to further diagnostic colonoscopy. This identified a neoplasm and potential perforation at the proximal rectum. An exploratory laparotomy confirmed the presence of a hematoma and an aneurysm invading the rectal wall, necessitating partial rectal resection, intestinal anastomosis, and ileostomy. Postoperative recovery was successful, with no further bleeding incidents and normal follow-up CT and colonoscopy results after six months. CONCLUSION In cases of unusual gastrointestinal bleeding, it is necessary to consider vascular causes for effective diagnosis and intervention.

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“…Traditional aneurysmal disease, including thoracic aortic aneurysms 18 , AAAs 19 , and visceral aneurysms 20 have a significant risk of rupture and resulting mortality regardless of patient characteristics; therefore, studies have appropriately focused on identifying size criteria for prophylactic repair of these aneurysms 21–23 . However, PAAs are anatomically constrained by surrounding muscles and tendons of the leg 24 , making rupture a rare outcom 5 .…”

Section: Discussionmentioning

confidence: 99%

Percent Thrombus Outperforms Size in Predicting Popliteal Artery Aneurysm Related Thromboembolic Events

Bellomo,

Goudot,

Lella

et al. 2023

Preprint

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IntroductionPopliteal artery aneurysms (PAAs) are associated with high morbidity and mortality and current Society for Vascular Surgery (SVS) recommend operative repair for PAAs with a diameter greater than 20 mm, which is based on limited evidence. To help risk stratify patients for surgery, our aim was to identify anatomic characteristics of PAA associated with limb threatening and thromboembolic events (TEs).MethodsA retrospective multi-institutional cohort was queried for all patients with a PAA from 2008 to 2022. Symptom status at the time of presentation was divided into three categories: symptomatic PAA with documented claudication or chronic limb ischemia (CLI), limb threatening PAA with a TE, acute limb ischemia, or rupture, and asymptomatic PAA without symptoms or limb threatening events. Patient and anatomic factors based on duplex ultrasound (DUS) were evaluated as potential predictors of symptom groups and thresholds of anatomic variables were identified using receiver operating characteristic curves.ResultsThere were 470 PAAs identified in 331 patients. The mean age was 74 years at diagnosis, 94% of patients were white, and 97% of patients were male. Cardiovascular comorbidities were prevalent in and similar between all patient groups studied, and almost all patients were on anticoagulation or antiplatelet therapy at the time of diagnosis, at 96%. The most common concurrent aneurysm was abdominal aortic aneurysm (62%). Patient comorbidities were not associated with symptom status. PAAs with a higher percent thrombus burden were 18 times more likely to experience a limb threatening event and 24 times more likely to experience a TE. A largest diameter threshold of 20.4 mm was predictive of a TE (sensitivity 78.1%, specificity 40.5%), but percent thrombus threshold of 62% outperformed largest diameter as a predictor of a TE (sensitivity of 81.3%, specificity 52.0%). Percent thrombus threshold of 73% also predicted limb threatening events (sensitivity 65.7%, specificity 69.7%).ConclusionA PAA diameter greater than 20.4 mm was predictive of TEs, which is in agreement with clinical practice guidelines. However, percent thrombus greater than 62% outperformed largest diameter as a predictor of a TE. This analysis supports the use of size greater than 20.4 mm and 62% thrombus in identifying high risk PAAs that warrant repair.

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Natural history and growth rates of isolated common iliac artery aneurysms

Cited by 15 publications

References 11 publications

Prevalence of isolated iliac aneurysm in patients with acute aortic dissection: a five-year clinical retrospective study

Prevalence of isolated iliac aneurysm in patients with acute aortic dissection: a five-year clinical retrospective study

Hematochezia due to rectal invasion by an internal iliac artery aneurysm: A case report

Percent Thrombus Outperforms Size in Predicting Popliteal Artery Aneurysm Related Thromboembolic Events

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