Ruptured Iliac Artery Aneurysms

in Aortic Aneurysmal Disease

Applied

Type

Modification

Confidence

90%

Created

Mar 26, 2026

Evidence

3 sources

Rationale

The section was updated to include recent outcome data for ruptured iliac aneurysms and to align elective repair thresholds with the latest international guidelines. Per the instructions, abbreviations were expanded on first use. Geographic balance was achieved by citing both the 2022 ACC/AHA and 2024 ESVS guidelines alongside the existing SVS citation.

Evidence

Isselbacher EM, et al. 2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines. Circulation. 2022. PMID: 36322642.
Verified source
PubMedDOI
Svetlikov AV, et al. [Review of the European Society for Vascular Surgery (ESVS) 2024 Clinical Practice Guidelines on the Management of Abdominal Aorto-Iliac Artery Aneurysms: what is new and prospects for development]. Angiol Sosud Khir. 2024. PMID: 41801947.
Verified source
PubMedDOI
Laloo R, et al. Postoperative outcomes are significantly worse among patients undergoing repair of ruptured versus unruptured iliac artery aneurysms – a 10-year longitudinal cohort study. BJS. 2022. DOI: 10.1093/bjs/znac242.066.
Verified source
DOI

Content Changes

* Ruptured iliac artery aneurysms (IAA) are uncommon; many coexist with abdominal aortic aneurysm (AAA) and are treated within an aorto-iliac repair strategy. Postoperative outcomes are significantly worse for patients undergoing repair of ruptured versus unruptured IAA [@laloo2022].
* Endovascular aneurysm repair (EVAR) is preferred when anatomy allows, with hypogastric preservation via iliac branch devices if feasible; internal iliac embolization may be necessary but increases risk of buttock claudication and pelvic ischemia [@rutherford2018-rutherford].
* Open repair remains important when endovascular seal/accessseal or access is not possible or in the presence of infection. ConsiderCurrent thresholdsguidelines recommend a threshold of ≥3.5 cm for intactelective diseaserepair (commonof isolated common iliac ≥3.5artery cm)aneurysms in(CIAA) elective[@svs2018] contexts[@aha2022] [@svs2018].[@esvs2024].
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