Aneurysmal degeneration of the iliac arteries (common, internal, external iliac) can occur in isolation, or in association with other large vessel aneurysms (eg, abdominal aorta, femoral artery).
Iliac artery aneurysms (IAAs) are often diagnosed as a result of screening or other imaging studies. Symptoms do not typically occur unless the aneurysm is large and are primarily related to compression of surrounding structures. Like abdominal aortic aneurysms, IAAs have a propensity for life-threatening rupture as diameter increases. On occasion, aneurysm thrombosis may lead to peripheral thromboembolism or acute limb ischemia.
The management of asymptomatic IAAs depends upon the size of the aneurysm, the presence or absence of coexisting abdominal aortic aneurysm or other aneurysm (eg, femoral, popliteal), and patient comorbidities. Patients with symptomatic IAAs should be referred for prompt vascular evaluation and repair.
The diagnosis and management of IAAs will be reviewed here. The surgical and endovascular management of IAAs is reviewed elsewhere. (See "Surgical and endovascular repair of iliac artery aneurysm".)
Seventy percent of iliac aneurysms occur in the common iliac artery, while 20 and 10 percent are found in the internal and external iliac arteries, respectively . About two-thirds of patients with IAA have involvement or more than one segment of the iliac arterial tree; one-third of IAAs are bilateral .