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

Isolated external iliac artery aneurysm in a patient without any concomitant vascular disease

Iliac artery aneurysms commonly present in patients with associated aortic disease. Isolated aneurysms of the iliac arteries are uncommon, mostly involving the common iliac artery. Isolated external iliac artery aneurysms are the rarest iliac aneurysmal pathology. We present the case of an asymptomatic isolated external iliac artery aneurysm with no other concomitant vascular disease in a middle-aged man, treated with a stent graft.

Isolated external iliac artery aneurysm: a rare case presentation of IgG4-related disease

Isolated external iliac artery aneurysm is a rare occurrence. These aneurysms have varied presentations depending on size and proximity. Both open surgical and endovascular modalities can be used for treatment depending upon presentation, aneurysmal anatomy, and patient condition. Preservation of at least one internal iliac artery is important to prevent post-repair hypogastric ischemia. There are no previous reports of IgG4-related disease (IgG4-RD) as etiology of these aneurysms. A 32-year-old male patient presented with a left lower abdominal lump and was found to have a left external iliac artery aneurysm on computed tomography angiography. The patient underwent iliofemoral bypass with an 8 mm polyester graft. Histopathological examination of the aneurysm wall suggested IgG4-RD. The patient fulfilled the 2020 Revised Comprehensive Diagnostic Criteria for IgG4-RD. An 18-Fluorodeoxyglucose-Positron Emission Tomography scan performed in the postoperative period showed no active disease, hence medical therapy was not instituted. The patient is doing well at 1 year.

A surprising diagnosis in a young patient with intermittent claudication: Symptomatic isolated external iliac artery aneurysm associated with cystic media necrosis

Aneurysms of the external iliac artery are extremely rare. We present a case of a middle-aged male patient with calf claudication owing to peripheral arterial embolism on the basis of a thrombosed true aneurysm of the external iliac artery caused by cystic media necrosis. Vascular imaging established the diagnosis and we proceeded to removal of the aneurysm via open repair, with excellent surgical and clinical results.