A Hybrid Internal Iliac Artery Reconstruction for Open Common Iliac Artery Aneurysm Repair

Common iliac artery (CIA) aneurysms present across a spectrum of anatomic variants that can pose unique operative challenges. A wide variety of procedural approaches have been described in the literature with current therapeutic options including both open and endovascular repair. These techniques may involve either ligation or embolization of the internal iliac artery (IIA) with reliance on collateralized blood flow to the pelvis to mitigate postoperative complications. However, preservation of the IIA is often preferred. This case report describes a hybrid surgical approach for treating CIA aneurysms while preserving IIA perfusion. Our technique mitigates the risks of hypogastric artery dissection (including hypogastric vein injury) in the presence of a large CIA aneurysm.