Few internal iliac artery aneurysms rupture under 4 cm

• Published in: Journal of vascular research 2017-01, Vol.65 (1), p.76-81
• Main Authors: Laine, Matti T., MD, Björck, Martin, MD, PhD, Beiles, C. Barry, MB BCh, FRACS(Vasc), Szeberin, Zoltán, MD, PhD, Thomson, Ian, MBChB, FRACS, Altreuther, Martin, MD, Debus, E. Sebastian, MD, PhD, Mani, Kevin, MD, PhD, Menyhei, Gábor, MD, PhD, Venermo, Maarit, MD, PhD
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Aneurysm, Ruptured - diagnostic imaging; Aneurysm, Ruptured - epidemiology; Aneurysm, Ruptured - mortality; Aneurysm, Ruptured - surgery; Aortic Aneurysm - diagnostic imaging; Aortic Aneurysm - epidemiology; Aortography - methods; Australia - epidemiology; Blood Vessel Prosthesis Implantation; Computed Tomography Angiography; Disease Progression; Elective Surgical Procedures; Europe - epidemiology; Female; Humans; Iliac Aneurysm - diagnostic imaging; Iliac Aneurysm - epidemiology; Iliac Aneurysm - mortality; Iliac Aneurysm - surgery; Kaplan-Meier Estimate; Male; Medical Records; Middle Aged; New Zealand - epidemiology; Predictive Value of Tests; Prevalence; Registries; Retrospective Studies; Risk Assessment; Risk Factors; Surgery; Time Factors; Treatment Outcome
• ISSN: 0741-5214; 1018-1172; 1423-0135; 1097-6809
• DOI: 10.1016/j.jvs.2016.06.109

Abstract Objective This study investigated the diameter of internal iliac artery (IIA) aneurysms (IIAAs) at the time of rupture to evaluate whether the current threshold diameter for elective repair of 3 cm is reasonable. The prevalence of concomitant aneurysms and results of surgical treatment were also investigated. Methods This was a retrospective analysis of patients with ruptured IIAA from seven countries. The patients were collected from vascular registries and patient records of 28 vascular centers. Computed tomography images taken at the time of rupture were analyzed, and maximal diameters of the ruptured IIA and other aortoiliac arteries were measured. Data on the type of surgical treatment, mortality at 30 days, and follow-up were collected. Results Sixty-three patients (55 men and 8 women) were identified, operated on from 2002 to 2015. The patients were a mean age of 76.6 years (standard deviation, 9.0; range 48-93 years). A concomitant common iliac artery aneurysm was present in 65.0%, 41.7% had a concomitant abdominal aortic aneurysm, and 36.7% had both. IIAA was isolated in 30.0%. The mean maximal diameter of the ruptured artery was 68.4 mm (standard deviation, 20.5 mm; median, 67.0 mm; range, 25-116 mm). One rupture occurred at