PMC10104685_01
Computed tomography - (A) Volume rendered image- anteroposterior view showing left external iliac artery aneurysm (yellow arrow); (B) cross-sectional image showing aneurysmal dilation of left external iliac artery with intramural thrombus (blue arrow). The right external iliac artery and bilateral internal iliac arteries are normal.
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Tomography Angiography (CTA) of the abdomen and bilateral lower limbs showed focal fusiform dilatation of the left external iliac artery (6X6.3X8.7 cm), 4.6 cm distal to the bifurcation of the left common iliac artery, with eccentric thrombus, and a proximal neck of 10.7 mm and distal outlet of 10.7 mm. The venous system was unremarkable (Figure 1).
Intra-operative images (A) Large left external iliac artery aneurysm with proximal (blue silastic tape looping left EIA) and distal (red silastic tape looping left CFA) vascular control with Silastic tapes; (B) Reconstruction with 8mm polyester graft.
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Iliofemoral bypass was done using an 8 mm polyester graft from the left external iliac artery to the left common femoral artery (Figure 2).
(A) Thickened arterial wall with intimal and adventitial thickening and complete loss of elastic tissue from media; (B) perivascular plasma cell-rich inflammation, which had abundant IgG4-positive cells (inset).
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There were no atherosclerotic changes in the intima (Figure 3).