There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.
Abstract
Fifty-five patients with 72 aneurysms of the iliac vessels were evaluated retrospectively
during a 12-year period (1972 to 1985). Atherosclerotic vascular disease was found
in all aneurysms. Marked male predominance (5:1) and advanced age (mean 74.6 years)
characterized this population group. Two thirds of them harbored multiple aneurysms
and isolated aneurysms were found primarily to involve the internal iliac artery (12
of 18 patients). Although symptomatic presentation varied with anatomic location and
presence of rupture, most patients were either asymptomatic (45%) or had such nonspecific
complaints (11%) that diagnosis was often delayed or erroneous. A mass detected during
abdominal, rectal, or vaginal examination was found in 39 patients (70%). Aneurysm
size ranged from 2.5 to 18 cm (mean 5.5 cm) for the entire group. Internal iliac aneurysms
tended to be larger (7.7 cm) yet demonstrated no increased risk of rupture, which
was encountered in 33% of patients. Elective operative management was undertaken in
26 patients with a mortality rate of 11%. When repair had to be performed as an emergency
procedure mortality increased to 33%. Aneurysm ligation, resection, or endoaneurysmorrhaphy
coupled with graft interposition when necessary did not seem to influence patient
survival. Eleven patients treated nonoperatively demonstrated enlargement in three,
rupture in one, and progressive ureteral obstruction in one patient. Iliac aneurysms
demonstrate expansile growth with eruptive and erosive complications and therefore
should be managed aggressively under elective circumstances.