PMC8609148_01
3D reconstruction from computed tomography angiography of the left iliac artery aneurysm from a posterior oblique perspective to demonstrate the relationship with the bifurcation and branches.
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Pelvic ultrasound and computed tomography (CT) angiogram showed an unruptured and uninflamed 28 mm saccular aneurysm projecting inferomedially from the iliac bifurcation into the internal iliac artery with no thrombus, and preservation of external and internal iliac arteries measuring 7 mm in diameter (Fig. 1).
Intra-operative image of the left iliac artery aneurysm immediately before excision.
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The left common, external, and internal iliac arteries were isolated to allow for full exposure of the aneurysm, which was found to involve predominantly the internal iliac artery origin (Fig. 2) and was clear of adjacent tissue.
Duplex ultrasound of the abdomen at 12 month follow up showed triphasic flow through the common (CIA)-external (EIA) iliac artery, as well as retrograde triphasic flow into the ligated internal iliac artery (IIA) stump.
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The left common and external iliac arteries remained patent with an antegrade triphasic waveform on duplex ultrasound, and the left internal iliac artery stump was also noted to have a retrograde triphasic waveform, indicating excellent quality collateral arterial supply (Fig. 3).