Pear-Shaped Multiple Iliac Artery Aneurysms

Isolated iliac artery aneurysms are seen much less frequently than are abdominal aortic aneurysms. Usually these aneurysms are asymptomatic and, for the most part, occur in patients who are 60 years of age and older. Men are 6–7 times as likely as women to develop such aneurysms. Isolated iliac artery aneurysms occur most often in the common iliac artery (70%), and are bilateral in 23%. ¹

We report the case of a 72-year-old man with multiple aneurysms of the iliac artery with bilateral involvement. The physical examination revealed a bruit over the lower abdominal quadrants. An electrocardiogram showed ST and T segment changes. Results of blood chemistry tests were within normal limits. Cardiac catheterization showed good left ventricular function but inoperable coronary artery disease. Magnetic resonance imaging revealed 90% left internal carotid artery stenosis and multiple bilateral iliac artery aneurysms (Fig. 1).

Fig. 1 Magnetic resonance image shows multiple iliac artery aneurysms that have a pear-shaped appearance. The aneurysm on the left originates from the right common iliac artery, and the ones on the right originate from the left common and the left internal iliac artery, respectively.