Iliac Artery Aneurysm

An iliac artery aneurysm is a rare bulging or stretching of a weak part of your iliac artery’s wall in your pelvic region. This vessel is below your waist and brings blood from your aorta to your lower body. With this condition, your iliac artery expands and puts pressure on nearby structures.

With time, the aneurysm can get larger. This increases the risk of it breaking open (rupturing) and bleeding inside your body. This can be fatal. Surgery can prevent or repair a rupture.

Symptoms of iliac artery aneurysm

Some people don’t have symptoms. A provider may find the aneurysm when performing imaging for another reason. Iliac artery aneurysm symptoms may include:

• Pain in your belly, pelvis, rectum or back
• Trouble peeing if the aneurysm presses on a tube (ureter) that carries pee from your kidney to your bladder
• Urge to pee or poop, but nothing coming out (tenesmus)
• Constipation
• Sudden pain in your belly, flank or groin (could mean the aneurysm ruptured)
• Nerve disease from pressure on nerves
• Leg swelling from pressure on a nearby vein

Iliac artery aneurysm causes

Common iliac artery aneurysm causes include:

• Hardening of your arteries (atherosclerosis)
• Bacterial infections
• Pregnancy
• Injury from a surgery

Risk factors

Some risk factors are things you can change or treat. You may have a higher risk of an iliac artery aneurysm if you:

• Have a history of trauma or infection
• Have a biological family history of aneurysms or dissections
• Are male
• Are over 60
• Have high blood pressure
• Have high cholesterol
• Use tobacco

How doctors diagnose this condition

A healthcare provider will do a physical exam and ask about your medical history. They most often use ultrasound to screen for an aneurysm and watch its growth. But they can also use a CT angiogram.

How is it treated?

You may need an iliac artery aneurysm repair if the stretched-out part is about 3 centimeters (over 1 inch) or more around. At this size, an aneurysm can break open. If this happens or you have symptoms, you may need surgery.

You may have open or minimally invasive surgery, depending on your situation.

A healthcare provider will also repair the aneurysm if you already need surgery on your aorta. (People usually have an aneurysm in their aortas if they have one in their iliac arteries.) A surgeon can do both repairs in the same operation. They may use a fabric graft to strengthen or replace the artery wall.

If the aneurysm is small, the risk of it breaking open is low. In that case, your provider will check the size of the aneurysm once a year or every few years to see if you need surgery later. In the meantime, they’ll treat other conditions you have and ask you to stop using tobacco products.

When should I see my healthcare provider?

Keep your regular checkup appointments with your provider so they can watch the size of the iliac artery aneurysm. Let them know if you start to have new symptoms or if your symptoms change.

Questions to ask your provider may include:

• What size is the aneurysm?
• How often do you need to check it?
• Which kind of surgery makes sense for me?
• What can I expect after surgery?

What can I expect if I have this condition?

An iliac artery aneurysm can get bigger and break open without warning. This can be fatal. Early diagnosis and treatment may prevent the artery wall from breaking, which can improve your outlook. Larger aneurysms expand faster than smaller ones. You may need more frequent checkups if you have a larger aneurysm.