Rupture of an Aneurysm of the Left External Iliac Artery During Pregnancy

Ruptured isolated external iliac artery true aneurysm associated with cystic medial necrosis: Report of a case

“…According to the current review, pathologic analysis was performed in fi ve patients and showed cystic medial change, CMN, or congenital change in four (80%), even though the most common cause of other true aneurysms is atherosclerosis. 2,5,6 This pathological characteristic may correlate with the external iliac artery, which is an unusual site for an atherosclerotic aneurysm. Cystic medial necrosis is one of the major pathological changes of the aorta; seen in aneurysms and dissections.…”

“…Our search of the English-language medical literature found 11 cases of isolated true aneurysms of the external iliac artery, including the present case, as summarized in Table 1. [2][3][4][5][6][7][8] Aortic aneurysms are associated with a high incidence of rupture, whereas peripheral artery aneurysms are associated with a high incidence of thrombosis and distal embolism. 9 According to our review, there were four (36%) ruptured EIAAs and one (9%) EIAA associated with peripheral embolization.…”

“…2,5,22 Crivello et al suggested that iliac artery aneurysms caused by CMN present signifi cantly higher operative risks because of their vascular fragility. 5 Although the pathological fi ndings revealed CMN in our patient, fortunately arterial vulnerability was not recognized.…”

“…23 Reported surgical procedures for isolated EIAAs consist of stent grafting (36%), graft replacement (27%), bypass procedures (18%), and common iliac artery ligation (9%). 2,5,22 Stent grafting is novel, but still presents challenges. Caronno et al stated that its usefulness lay in the fact that it was not associated with primary technical failure, major complication, or perioperative mortality.…”

“…[1][2][3][4][5][6][7][8] We report how we successfully treated a woman with an isolated external iliac artery aneurysm (EIAA) caused by cystic medial necrosis (CMN) and review the clinical manifestations of this rare entity as described in the literature.…”