Branches Of Iliac Artery Research Articles

An extremely rare bifurcation pattern of the caudal abdominal aorta: case report demonstrated by angiography

An extremely rare bifurcation pattern at the caudal abdominal aorta was encountered on the pelvic angiography and MR angiography of a male patient. Instead of dividing into two common iliac arteries, the caudal abdominal aorta first gave the right external iliac artery at the level of the last lumbar arteries, then bifurcated into a right internal iliac artery and a left common iliac artery. The median sacral artery originated at this anomalous bifurcation. This high origin of the right external iliac artery and separate branching of these right iliac vessels from the abdominal aorta are important during the interventions in the region. We present the angiography findings and discuss the embryological origin of this unusual and unreported congenital anomaly.

Internal Iliac Artery Branch Graft for Common Iliac Artery Aneurysm Following Previous Open Abdominal Aortic Aneurysm Repair

To demonstrate the use of a commercially available branch stent graft system, designed to preserve the internal iliac artery (IIA) in common iliac artery (CIA) aneurysms (CIAA) in two patients, who had undergone previous abdominal aortic aneurysm (AAA) surgery.

Prefabrication of a Conjoint Flap Containing Xenogenic Tissues

Conjoint flaps are the compound flaps possessing multiple independent flaps, each with an independent vascular supply, but linked by a common indigenous source vessel. We have developed a new model of flap prefabrication using autogenic and xenogenic tissues in rats. Flaps were prepared at abdomino-inguinal regions of 20 male wistar albino rats. Autologous muscle, fascia, cartilage, bone grafts and acellular human dermal matrix (Alloderm, LifeCell Corp., Branchburg, NJ) were wrapped on the branches of external iliac, inferior epigastric and femoral arteries. The feasibility of prefabricating autogenic and xenogenic tissue containing flaps was investigated experimentally. Four weeks later, flaps were dissected and histopathological evaluation was undertaken. New blood vessel development was detected in all specimens with varying degrees. To our surprise, acellular dermal matrix (Alloderm), which was used as a xenogenic graft, exhibited a better revascularization potential than autogenic grafts in this prefabrication process, and a relatively dense network of new vessel formation was seen. As acellular dermal matrix is an allogenic tissue for human beings and has a superior revascularization potential, it can be prefabricated together with different autogenic tissues, and this flap can be used to reconstruct massive composite tissue defects, such as the defects occurring after tumor resection in head and neck region. With this method, donor site morbidity will be dramatically reduced. This is the first attempt of conjoint flap prefabrication using autogenic tissues combined with xenogenic tissues, which creates a new type of flap combining tissues from different species. We believe that new flap prefabrication models will be developed in the future, on the basis of this study.

Patient Presentation and Management of Labial Ulceration Following Uterine Artery Embolization

Uterine artery embolization is a safe and effective procedure for the treatment of symptomatic uterine fibroids. Nontarget embolization of adjacent internal iliac artery branches is a reported complication of uterine artery embolization. The following report describes the presentation and management of ulcerations of the labium minora due to nontarget embolization of the internal pudendal artery.

Lumbosacral plexopathy associated with aortoiliac occlusive disease

Lumbosacral plexopathy associated with aortoiliac occlusive disease

A Statistical Method to Evaluate the Effect of Shear Stress on Endothelial Gene Expression in vivo

Objective To determine the effect of hemodynamic shear stress on endothelial gene expression in vivo. Methods Computational fluid dynamics (CFD) simulations were performed in three realistic models of the porcine abdominal aorta and its iliac artery branches. Using these calculations, a shear stress probability map in the iliac arteries was generated. This map showed the likelihood that a particular location would experience high, medium, or low time average shear stress. Based on this map, three anatomical regions likely to experience high, medium, and low shear stress levels were identified. The median time-average shear stress in these regions were 32.1, 15.2, and 9.7 dyn/cm2, respectively. Subsequently, endothelial cell RNA was collected from these regions in five additional porcine iliac arteries. Gene expression of select genes was measured in these samples using quantitative real time PCR. Results for the high and low shear regions are reported relative to the medium shear region. Results Expression of the genes tubulin, beta-catenin, c-jun, MCP-1, and VCAM was elevated in both the low and high shear stress regions relative to the medium shear region. ICAM expression was downregulated in both the low and high shear regions relative to the medium shear region. These effects were significant in nearly all cases. Conclusions This statistical method permits evaluation of phenotypic differences that arise due to hemodynamic forces in in vivo specimens. Arterial regions subjected to distinct levels of time average shear stress exhibit differences in endothelial gene expression. Supported by NIH grant H50442.

Multifocal arterial haemorrhage in a partially stable pelvic fracture after a crush injury: a case report

Most pelvic haemorrhages are thought to be caused by injury to small arteries or veins in the fractured cancellous pelvic bone or in the surrounding soft-tissues, and only 6-18% of patients with unstable pelvic fractures have haemorrhage from larger arteries. When arterial injuries are present, the majority involve branches of the internal iliac artery with only few published reports of injuries to the external iliac artery or its branches. We report of a patient who sustained a combined pelvic and acetabular fracture with multifocal bleeding involving branches of both the internal iliac as well as the external iliac arteries after a crush injury. The primary attention was focused on the most probable arterial injury, the internal iliac artery and only at repeat angiography was the injury to the internal epigastric artery, caused by degloving injury to the trunk, recognized. Arterial control was achieved only following aggressive fluid resuscitation, pelvic packing, repeated embolization and ligation of the peripelvic inferior epigastric artery. After initial haemodynamic control was achieved, the patient sustained multiple complications, partly as a consequence of the injury, but also as a consequence of the life-saving treatments. The case describes a rare combination of arterial injuries in a complex pelvic fracture constituting a partially stable pelvic fracture and a dislocated acetabular fracture in a patient with pelvic crush injury and a degloving injury to the trunk. The case also describes the complex nature of these injuries and rarely reported problems related to the treatment of them.

Aberrant ovarian artery supply of uterine sarcoma: a cause of rebleeding following uterine artery embolization

Transcatheter embolization has an increasingly important role in the treatment of inoperable lifethreatening haemorrhage as a complication of advanced pelvic cancer. Usually a bleeding uterine sarcoma is supplied by branches of the internal iliac arteries. We describe a patient with massive pelvic haemorrhage due to a uterine sarcoma, that was not controlled by bilateral uterine artery embolization. Continued haemorrhage was due to a rare additional tumour blood supply arising from an aberrant ovarian artery, found on follow-up angiography and subsequently successfully embolized. This illustrates the importance of identifying other possible feeding vessels supplying pelvic tumours if bleeding is not controlled by embolization of the usual vessels supplying the organ.

Variability of the origin of the uterine artery: Laparoscopic surgical observation

To categorize the surgical anatomic variants of the origins of the uterine arteries and to clarify the difference in the description of the internal iliac artery in the contemporary anthropologic, radiologic and surgical system. One hundred women with symptomatic fibroids were treated using retroperitoneal laparoscopic dissection of the uterine vessels (LDUV). Retrospective evaluation of the operative records and videos was carried out. The anatomical classification of Adachi (type I-V) was modified for surgical purposes (type I-IV). Laparoscopic retroperitoneal dissection and LDUV were carried out successfully using an ultrasonic operative technique in all women. The branching of the branches of the internal iliac artery was studied on the right side of the pelvis. Of the 100 uterine arteries that were evaluated, 81% were classifiable types and 19% of surgical dissections were inconclusive. Classification was as follows: type I, 30.8%; type II, 23.4%; type III, 45.6%; and type IV was not found. Modified surgical classification type III (visceral branches arising from the umbilical artery and the internal pudendal artery) was claimed to be statistically the most common type. Laparoscopic dissection of the uterine artery close to the origin of the uterine artery can be carried out safely in the most frequent types of surgical classification. The meticulous dissection of the uterine artery in cases in which the uterine artery does not arise typically from an unobliterated segment of the internal iliac artery was recommended.

First military use of activated Factor VII in an APC-III pelvic fracture

A male soldier in shock with an APC-III pelvic fracture was flown to an Air Assault Surgical Group (AASG) of 16 Close Support Medical Regiment at Al Amarah in Iraq. A pelvic external fixator was applied and his condition stabilized. Ultrasound scanning (FAST) showed an absent bladder, and a spreading retroperitoneal haematoma combined with intra-abdominal, free blood. Unfortunately he continued to bleed and required transfusion with the unit's entire stock of type-specific blood. At emergency laparotomy, uncontrollable pelvic bleeding was encountered and the abdominal aorta required clamping above the iliac bifurcation. Branches of the right internal iliac artery were the source and this was ligated. Some bleeding continued post-operatively: administration of activated Factor VII was associated with a marked reduction in the oozing from his fixator pin-sites and an improvement in his pH from 7.1 to 7.3. In total, 25 units of blood were transfused, 8 of which were fresh whole blood donated by individual members of the AASG. The patient survived, returned to the UK, had his injuries reconstructed, and is currently undergoing rehabilitation. This case illustrates the benefits of forward resuscitation surgery in wartime and the need for a multidisciplinary approach to trauma care.

Angiographic documentation of the efficacy of recombinant activated factor VII (NovoSeven) to control diffuse bleeding in major trauma

A 54-year-old female was admitted to the emergency department, following a fall of approximately 18 meters. On arrival, the patient was shocked with a blood pressure of 80/10 cm Hg, a heart rate of >100. She was sedated and mechanically ventilated. The arterial pH was 7.14 with a base deficit of 16 mEq/L. Radiological investigations revealed a pneumothorax, multiple costal fractures as well as a displaced fracture of the right forearm and open fractures of the left and right tibia. The patient’s condition continued to deteriorate, with persistent haemorrhage and was referred for urgent angiographic assessment. The angiogram demonstrated diffuse oozing from the branches of the right internal iliac artery, the right deep femoral artery and the right subclavian artery. An arterial embolization with gelfoam and microspheres (Embogold™) was successfully performed in the vascular network arising from the . . .

The Proteus Syndrome Associated With Life Threatening Hematuria

The Proteus syndrome (PS) is a recently defined rare hamartomatous disorder. 1 PS comprises an association of verrucous epidermal nevi, infantile hemangiomas, lipomalike subcutaneous hamartomas and asymmetrical overgrowth of almost any part of the body. Vascular anomalies of the gastrointestinal tract, spleen, kidneys and testicles have been reported. To our knowledge we report the first case of bladder involvement in PS. CASE REPORT A 2-year-old girl was admitted to the hospital for treatment of extensive verrucous nevi and large hemangiomas involving mainly the right hemibody. The lesions also involved the right mandibular and periorbital area. The cutaneous lesions had been present since birth and were progressively increasing. She had multiple recent episodes of gross hematuria. The only laboratory abnormality was microscopic hematuria. The gross hematuria episodes prompted complementary evaluation of the urinary tract and adjacent organs. Thoracic, abdominal and pelvic computerized tomography revealed extensive vascular (venous) lesions involving the right lung, right medulla and right hemipelvis overlying a thickened and irregular bladder. The kidneys and ureters were normal. Voiding cystogram confirmed the irregular and nodular aspect of the right hemibladder wall (fig. 1). At cystoscopy extensive venous lesions involving the right hemibladder (excluding the trigone) were seen (fig. 2). Within a few days the child returned with acute massive gross hematuria with clot. A pre-shock state (hemoglobin 38) led to immediate intervention with a combination of selective bilateral internal iliac artery branch embolizations, cystoscopic declotting and bladder irrigation, which achieved control of the bladder hemorrhage. Because this child lived in a remote area, we had to consider a more definitive treatment. We opted for an endoscopic approach using a potassium titanium phosphate laser. At the time of surgery balloon catheters were placed in the internal iliac arteries in case of massive bleeding and conversion to open surgery. The venous lesions were treated in a sweeping fashion using 193 J total energy. At 3-year followup gross hematuria had not recurred and the child was thriving well. Control cystoscopy revealed an important but incomplete regression of the venous lesions. DISCUSSION To our knowledge the association of extensive intravesical venous lesions and PS has not been reported previously, and was a therapeutic challenge. An open approach (partial cystectomy) was entertained. However, the extent of the pelvic vascular anomalies seen on computerized tomography and arteriogram with the risk of major hemorrhage leading to total cystectomy and ileal conduit led us to opt for a more conservative endoscopic approach. Endoscopic treatment of bladder vascular lesions (hemangiomas) is well recognized. Smith reported the use of neodymium:YAG laser coagulation in bladder hemangiomas associated with the Klippel-Trenaunay syndrome (a syndrome related to PS). 2 We chose potassium titanium phosphate laser because of its excellent coagulation capabilities and superficial tissue penetration. 3 Despite the favorable out

Systematic study of the internal iliac artery in llama ( lama glama)

The aim of this research was to determine the origins of the parietal and visceral branches of the internal iliac artery of the llama and to match those with the known types and classifications in the human being and domestic animals. The internal iliac artery divides at the level of the third sacral vertebra into the caudal gluteal and internal pudendal arteries corresponding to an intermediate long iliac type. It gives off the following collateral branches: umbilical, cranial gluteal, obturator and iliolumbar arteries. The intrapelvic visceral branches, vaginal or prostatic arteries, arise from the internal pudendal artery as occurs in carnivores. This is an important difference in relation to the distribution in characteristic long iliac and artiodactyla types. The origins of the parietal and visceral branches of internal iliac artery in the llama have characteristics in common with the domestic cat, which belongs to the carnivores. In relation to the Adachi classification, the internal iliac artery of the llama will be included in the IVa type. We believe that this study is a contribution of a new aspect in teaching and research in comparative anatomy.

Technique and results of transfemoral superselective coil embolization of type II lumbar endoleak.

This study was undertaken to describe the technique of transfemoral superselective coil embolization of type II endoleak and its influence on abdominal aortic aneurysm diameter. Over 23 months, 104 aortic stent grafts were deployed to exclude abdominal aortic aneurysms, at an academic medical center. Increase in aneurysm diameter and perigraft findings on contrast material-enhanced computed tomography scans prompted arteriography. Procedures were performed solely by vascular surgeons in a surgical angiography suite. In 7 patients aneurysm access was via the iliolumbar branches of the internal iliac artery, and in 1 patient aneurysm access was via the inferior mesenteric artery through the arc of Riolan from the superior mesenteric artery. Coaxial catheters were placed to gain access to the aneurysm (8F to 5F to 3F, or 5F to 3F). A 3F Tracker18 was the most distal catheter through which an assortment of 0.018 microcoils were deployed within the aneurysm, and the origin of the feeding vessels when possible. Aneurysm diameter increased 0.48 +/- 0.2 cm over 10.8 +/- 5 months before superselective coil embolization. In 6 of 8 patients superselective coil embolization embolization resulted in a mean decrease in aneurysm diameter of 1.3 +/- 1.2 cm over 9 +/- 3.2 months. Failure was presumed due to inability to reach the aneurysm sac in 1 patient and was associated with oral anticoagulation in 1 other patient. Proper identification of the source of type II endoleak and its complete occlusion, combined with aneurysm sac coiling, may result in prompt decrease in aneurysm size.

Effects of prolactin administered to a perfused area of the skin of Angora goats.

It is suspected that prolactin may affect mohair growth; therefore, effects of infusing prolactin on mohair growth were investigated using a skin perfusion technique. Seven Angora wethers (average body weight, 30 +/- 3 kg) were implanted bilaterally with silicon catheters into the superficial branches of the deep circumflex iliac artery and vein. For the first 14 d of the experiment, animals were infused (2.4 mL/h) with prolactin (one side) or control (other side) into the deep circumflex iliac arteries. The infusion rate of prolactin was 2.21 mg/d and was calculated to triple prolactin blood concentration in the perfused region. The area of skin supplied by the deep circumflex iliac artery was approximately 240 cm2. Two weeks after the cessation of infusions, 100-cm2 areas within the perfused regions were shorn to determine mohair growth. Greasy and clean mohair production was decreased (P < 0.05) by prolactin compared with control (3.79 vs 4.62 and 3.02 vs 3.67 g/[100 cm2 x 28 d], respectively). Oxygen satura tion in blood hemoglobin from the deep circumflex iliac veins was greater (P < 0.02) on the side infused with prolactin than on the control side (75.1 vs 68.2%). Higher concentrations of methionine, lysine, valine, isoleucine, and leucine were observed in blood of the deep circumflex iliac vein on the side infused with prolactin vs that infused with control (P < 0.05). In conclusion, direct skin infusion with prolactin decreased mohair fiber synthesis by the skin and may have concomitantly lessened oxygen consumption. Thus, effects of increasing prolactin concentration approximately two-fold in the skin on mohair fiber growth may not be limited to simple competition for nutrients between skin and other tissues such as the mammary gland.

Vaskuläre Verletzungen im Iliaca-Stromgebiet beim Beckentrauma: Diagnostik - Inzidenz - Behandlungsstrategie - Outcome

Eine der Haupttodesursachen nach schweren Beckenverletzungen ist der akute hämorrhagische Schock. Typische Blutungsquellen sind hierbei die großen venösen Plexus des Beckens, großflächige spongiöse Frakturzonen und Rupturen von Gefäßen des Stromgebietes der Arteria iliaca. Im Rahmen dieser Studie erfolgte die Charakterisierung des Patientengutes mit kombinierter knöcherner und arterieller Beckenverletzung. Erfasst wurden sämtliche Patienten mit Beckenfrakturen, die in der Unfallchirurgischen Abteilung der Universitätsklinik Freiburg in den Jahren zwischen 1991 und 1999 (5 Jahre prospektiv, 4 Jahre retrospektiv) behandelt wurden. Dabei zeigte sich, dass bei 17 (3,74 %) von 454 Patienten mit Beckenverletzungen zusätzliche vaskuläre Läsionen vorlagen. Durchschnittlicher ISS, PTS, der Anteil an Polytraumen, die Prävalenz von Frakturen mit rotatorischer und vertikaler Instabilität sowie die Mortalität der Patienten mit begleitender arterieller Verletzung der Beckengefäße lagen dabei deutlich über denen der Grundgesamtheit aller untersuchten Beckenfrakturen. In diesem Zusammenhang hat sich beim Management kreislaufinstabiler Patienten mit vorwiegend pelviner Blutungsquelle unter bestimmten Voraussetzungen die sofortige Arteriographie (70,59 %) gegebenenfalls in Kombination mit einer selektiven Embolisation (41,18 %) bewährt. In der Mehrzahl der Fälle muss jedoch chirurgisch und speziell gefäßchirurgisch interveniert werden. Während dem initialen Hb-Wert und dem initialen systolischen Blutdruck keine prognostische Bedeutung zukommt, liegt der Transfusionsbedarf der ersten 24 Stunden bei den später verstorbenen Patienten im Vergleich zu allen Patienten mit kombinierter knöcherner und vaskulärer Beckenverletzung nahezu doppelt so hoch und ist somit ein entscheidender, das Überleben bestimmender Parameter.

Severe Vaginal Bleeding Treated with a Stent Graft

Introduction tumour in the upper part of the vagina. The bleeding suddenly increased and became life threatening with Pelvic and genital haemorrhage is a major cause of hypovolaemic shock within hours after admission. Partially haemostasis was achieved by immediate morbidity and mortality in many gynaecological and obstetrical disorders and is often a major therapeutic transvaginal and aortic compression. Blood replacement was administered. Surgery was not conchallenge, especially in patients with malignant disease. In recent years, several case reports have demsidered as a possibility due to the patient’s unstable condition. It was decided to achieve haemostasis onstrated the effectiveness of percutaneous transluminal arterial embolisation in controlling through a percutaneous transluminal endovascular procedure. Haemostasis was initially achieved by plagynaecological haemorrhage when branches of the internal iliac artery are involved. However, incing a balloon (14 mm in diameter, Olbert balloon, Boston Scientific/Medi-tech, MA, U.S.A.) in the abvolvement of the external iliac artery seems much more uncommon and a different endovascular therapeutic dominal aorta below the renal arteries introduced through the left common femoral artery (Fig. 1). Angioapproach seems necessary. We describe an endovascular stent graft placement over an erosion of graphy, obtained from the right common femoral artery, revealed an erosion of the right external iliac the external iliac artery in a patient with recurrent endometrial carcinoma presenting with life-threatartery 3 cm from its origin which was haemorrhaging directly into the vagina (Fig. 2). ening vaginal bleeding. Through a 9 Fr. introducer sheath in the right common femoral artery a self-expanding nitinol stent graft (Passager stent graft, Boston Scientific, MA, U.S.A.) Case Report with a diameter of 8 mm and length of 6 cm was placed over the guide wire covering the erosion. Control A 64-year-old woman underwent radical hysterectomy angiography demonstrated a patent external iliac arand bilateral salpingo-oophectomy for endometrial tery without any leak (Fig. 3). The balloon in the distal adenocarcinoma in January 1996. No adjuvant therapy part of the aorta was deflated and there was no sign was given. Local recurrence was diagnosed 10 months of recurrent bleeding. The patient received 11 units of later and treated with external radiation therapy blood from the time of presentation to haemostasis. (46 Gy). Metastases in two vertebral bodies were disShe died 3 days later due to general deterioration, covered in May 1999, and the patient received local there was no evidence of recurrent vaginal bleeding radiation therapy (28 Gy) supplemented with horat this time. monal therapy. In November 1999, the patient was hospitalised with lower abdominal pain and acute vaginal bleeding. Gynaecological examination revealed an ulcerating Discussion

Effects of small peptides or amino acids infused to a perfused area of the skin of Angora goats on mohair growth.

The effect of infusing dipeptides or their amino acids on mohair growth of Angora goats was investigated using a skin perfusion technique. Seven Angora wethers (average BW 24 +/- 2.5 kg) were implanted bilaterally with silicon catheters into the superficial branches of the deep circumflex iliac artery and vein and carotid artery. The experiment consisted of three 28-d phases. In the first 14 d of Phases 1 and 3, saline was infused into deep circumflex iliac arteries supplying skin and in Phase 2 a mixture of dipeptides (methionine-leucine [Met-Leu], lysine-leucine [Lys-Leu]) was infused into the artery on one side, and free amino acids were administered on the other side. Infusion rates of peptides were 0.85 mg/h Met-Leu and 0.85 mg/h Lys-Leu in 2.4 mL saline. Infusion rates of amino acids were 0.474 mg/h Lys, 0.483 mg/h Met, and 0.743 mg/h Leu in 2.4 mL saline. A 100-cm2 area within the perfused region was used to determine mohair growth. Two weeks after the cessation of infusions, perfused areas were shorn. Clean mohair production from the dipeptide- and amino acids-perfused regions were similar (4.21 vs 4.35 g/[100 cm2 +/- 28 d], respectively; P > 0.05). However, clean mohair production during dipeptides and amino acids infusions was greater (P < 0.01) than that observed during saline infusions (3.63 g/[100 cm2 +/- 28 d]). There were no significant differences between dipeptides and free amino acids in concentrations of various hormones and metabolites in blood from deep circumflex iliac veins (P > 0.05). In conclusion, the studied small dipeptides and amino acids similarly increased mohair fiber growth, presumably through supplying limiting amino acids directly to the fiber follicle.

Morphological assessment of the umbilical cord with three-dimensional ultrasonography

ABSTRACTThe long cylindrical cord covered by a layer of amnion that extends from the umbilicus of the fetus to the fetal surface of the placenta is known as the umbilical cord, or, in older medical textbooks, as funiculis umbilicalis. The two umbilical arteries extend as branches of the internal iliac arteries that emerge from the fetal body at the umbilicus, and run a helical course through the umbilical cord carrying venous blood to the placenta. In most normal placentas, the umbilical arteries anastomose within 2 cm of insertion into the placenta. The fetal umbilical vein emerges from the placenta and carries oxygenated blood to the fetus. The cord vessels are supported by a matrix of myxomatous connective tissue known as Wharton's jelly. The average length of the umbilical cord is approximately 55 cm at term, but extreme variations in length can occur for unknown reasons. The normal umbilical cord is spiralled. On rare occasions, remnants of the omphalomesenteric and allantoic ducts may be found in th...

Rupture of Internal Iliac Artery Aneurysm into the Bladder following Aortic Aneurysm Repair

This report describes a case of ruptured internal iliac artery aneurysm into the bladder after repair of an infrarenal abdominal aortic aneurysm. Aortic repair consisted of resection of the aneurysm followed by prosthetic interposition to reestablish arterial continuity. During the postoperative period, the patient had ischemia of left colon, which was successfully treated by the Hartmann procedure. A right internal iliac artery aneurysm measuring 50 mm in diameter was demonstrated by an abdominal CT scan during the initial hospitalization but was considered stable, since ultrasonography showed no change in diameter at 3 months and 1 year. The patient was lost from follow-up until 3 years later when he was hospitalized after rupture of the right iliac artery aneurysm, then measuring 120 mm in diameter, into the bladder. Surgical repair was undertaken. The procedure involved aortobifemoral bypass with suture of the bladder defect and branches of the internal iliac artery by the endoaneurysmal route. Postoperative recovery was uneventful. Upon reexamination 1 month after discharge from the hospital, the patient was asymptomatic. This rare case confirms the gravity of internal iliac artery aneurysm and the importance of therapeutic management to prevent rupture.