Management of iliac artery aneurysm

IAA: iliac artery aneurysm; AAA: abdominal aortic aneurysm; PAD: peripheral artery disease.
* Indications for AAA repair include symptomatic or ruptured AAA, or asymptomatic AAA with diameter >5.5 cm, rapid expansion >1.0 cm/year, or associated peripheral artery aneurysm or PAD with indications for repair.
¶ Imaging IAA every 6 months after diagnosis, then if stable, annual surveillance.
Δ Iliac aneurysm expansion >1.0 cm/year or >0.7 cm in 6 months.
◊ Endovascular repair is generally preferred; open repair may be appropriate if decompressing the iliac aneurysm sac is necessary to relieve symptoms, or if preserving internal iliac artery flow is critical and endovascular means are not feasible.
§ Method of repair is determined by aortoiliac anatomy and pelvic circulation. Endovascular coil embolization of the hypogastric artery may be needed to achieve a proper seal of the endovascular graft components. Bilateral coil embolization for bilateral iliac aneurysm associated with AAA is less desirable, and if necessary, is better performed as a staged endovascular procedure.