Few internal iliac artery aneurysms rupture under 4 cm.

Area of Science:

• Vascular Surgery
• Aneurysm Research
• Medical Imaging Analysis

Background:

• Internal iliac artery aneurysms (IIAAs) are uncommon vascular conditions.
• IIAAs frequently coexist with other aortoiliac aneurysms, complicating diagnosis and treatment.

Purpose of the Study:

• To evaluate the rupture diameter of internal iliac artery aneurysms (IIAAs).
• To assess the adequacy of the current 3 cm threshold for elective IIAA repair.
• To investigate the prevalence of concomitant aneurysms and outcomes of surgical treatment for ruptured IIAAs.

Main Methods:

• Retrospective analysis of 63 patients with ruptured IIAAs from seven countries and 28 vascular centers.
• Computed tomography (CT) imaging at rupture used to measure maximal IIAA diameters.
• Data collection included surgical treatment type, 30-day mortality, and follow-up duration.

Main Results:

• The mean maximal diameter of ruptured IIAAs was 68.4 mm; only 6.3% ruptured at diameters less than 4 cm.
• Concomitant aneurysms were common: 65.0% had common iliac artery aneurysms, and 41.7% had abdominal aortic aneurysms.
• The 30-day mortality rate was 12.7%, with a 1-year survival estimate of 74.5%.

Conclusions:

• Internal iliac artery aneurysms (IIAAs) are rare and often associated with other aneurysms.
• Current evidence suggests monitoring IIAAs up to 4 cm may be reasonable, particularly in elderly men.
• Observed mortality for ruptured IIAAs was lower than previously reported and compared to ruptured abdominal aortic aneurysms.