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Iliac vein aneurysms: a comprehensive review.

Sina Zarrintan1,2, Niki Tadayon1,2, Seyed Moahammad Reza Kalantar-Motamedi1,2

  • 1Division of Vascular & Endovascular Surgery, Department of General & Vascular Surgery, Shohada-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Journal of Cardiovascular and Thoracic Research
|April 27, 2019
PubMed
Summary

Iliac vein aneurysms are rare vascular conditions. This review found 50 cases, highlighting external iliac vein aneurysms, often linked to trauma-induced arteriovenous fistulas, and discussing treatment options.

Keywords:
AneurysmArteriovenous FistulaIliac VeinVenous Malformation

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Area of Science:

  • Vascular Surgery
  • Vascular Medicine
  • Radiology

Background:

  • Iliac vein aneurysms are exceptionally rare, with the iliac venous tract being an uncommon site for venous aneurysms.
  • Undiagnosed or ruptured iliac vein aneurysms can lead to severe complications, necessitating a thorough understanding of this condition.

Purpose of the Study:

  • To systematically review all reported cases of iliac vein aneurysms in the literature.
  • To discuss the diagnostic challenges and therapeutic strategies for managing iliac vein aneurysms.

Main Methods:

  • A systematic literature search was conducted using MEDLINE and EMBASE databases from 1900 to March 2018.
  • Keywords included "iliac vein/veins/venous," "hypogastric," "inferior vena cava," and "aneurysm/aneurysms."
  • Fifty cases of iliac vein aneurysms were identified and analyzed.

Main Results:

  • The study identified 50 cases of iliac vein aneurysms, predominantly affecting males (64.6%) and occurring in the left iliac vein (58%).
  • The most common location was the external iliac vein (62%), often secondary to arteriovenous fistulas (AVF) resulting from trauma (32%).
  • Treatment modalities included open surgery (59.2%), conservative management (28.6%), endovascular treatment (10.2%), and hybrid approaches (2.0%).

Conclusions:

  • Iliac vein aneurysms are rare, requiring high clinical suspicion for diagnosis.
  • Treatment decisions depend on the patient's clinical presentation and imaging findings, with both open and endovascular techniques being viable options.
  • Men, left-sided aneurysms, and external iliac vein locations are more common, with traumatic AVF being a primary cause.