Iliac Vein Aneurysm Research Articles

Total Endovascular Repair of a Giant Iliac Vein Aneurysm: A Case Report and Review of Literature.

The iliac veins are the least frequent location for venous aneurysms, with only a few cases described globally. The etiology and clinical presentation of this extremely rare entity is diverse and unclear and no treatment consensus has been reached yet. Our purpose is to present an interesting iliac vein aneurysm (IVA) case that we treated in our department, with a brief review of the literature. We report a case of a 74-year-old male patient with a giant, 55 mm in diameter, asymptomatic, right common IVA, with concurrent aplasia of the left common iliac vein and an extensive network of venous collaterals. The patient was treated, under general anesthesia, with total endovascular iliocaval reconstruction through implantation of a 32 × 100 mm thoracic aortic tubular Ankura stent graft. The computed tomography venography at first-month follow-up showed the complete exclusion of the IVA, without any endoleak and the patient remains up to date free of symptoms and thromboembolic events. Twelve cases of endovascular treatment of IVA have been reported so far, and our case is the first with implantation of a thoracic aortic stent graft. Our results suggest that this technique is safe, effective, and may be considered for appropriately selected patients. This is the first case with total endovascular repair of an iliac vein aneurysm with contralateral iliac vein aplasia through endovenous implantation of a thoracic aortic stent-graft. Our results suggest that this technique is safe and effective and thus, may be considered for appropriately selected cases.

Successful Wallstent exclusion of iliofemoral venous aneurysms—a new treatment paradigm

Treatment of venous aneurysms involving the iliac and femoral veins has generally been an open surgical approach, with a few case reports noting use of an endovascular approach. We report three cases: (1) a patient with an iliocaval occlusion involving an occluded TrapEase filter who presented with a large left external iliac vein aneurysm; (2) a patient with a left common femoral vein aneurysm; and (3) a patient with left profunda femoris vein aneurysms with associated pulmonary embolism. All three patients were successfully managed with the use of appropriately sized bare metal woven stents (Wallstents; Boston Scientific). Their clinical presentation, technical considerations, and outcomes are reviewed.

Enteric fistulization of a common iliac vein aneurysm.

Iliac vein aneurysm is rare. Its complications include rupture, thromboembolism, and enteric fistulization. If a patient with surgical history presents with gastrointestinal bleeding, the veno-enteric fistula should be part of the differential diagnoses. In presence of a veno-enteric fistula, surgical treatment consists of aneurysmectomy, venorraphy, and intestinal resection.

Surgical Management of a Large Primary External Iliac Vein Aneurysm

Iliac vein aneurysms are rare, and the true incidence is unknown. Their etiology is either primary or secondary, and secondary aneurysms are often related to a traumatic arteriovenous fistula. They appear to have a male and left-sided predominance. Due to their rarity, the most appropriate surgical management has yet to be elucidated. Here, we highlight a case of a large primary external iliac vein aneurysm successfully repaired with interposition graft.

A Rare Finding of Thrombosed Bilateral Giant External Iliac Vein Aneurysms

A 70 year old man presented with severe left lower limb oedema and pain. He had a history of bilateral deep vein thrombosis 20 years ago. (A) Computed tomography phlebography revealed previously unknown bilateral thrombosed external iliac vein aneurysms (arrows), 45 mm and 63 mm on the right and left, respectively. The thrombus extended to both femoral veins being occlusive on the left side. (B) Transpopliteal catheter directed thrombolysis was performed on the symptomatic left side. Although venous aneurysm recanalisation was not achieved, the patient improved due to femoral vein and venous collateral blood clot lysis (arrowheads).Image 1

Primary external iliac vein aneurysm with generalized venomegaly.

Primary iliac vein aneurysms are exceedingly rare. We present the case of a 62-year-old man who, after left hip arthroplasty, was found on surveillance computed tomography to have an incidental right external iliac vein aneurysm (solid white arrow) with dilation of the inferior vena cava (IVC) (A; hollow white arrow). Magnetic resonance angiography demonstrated a 5.3-cm right external iliac vein aneurysm (B) and generalized venomegaly. The IVC was dilated to 36 mm (C; hollow white arrow) with renal vein ectasia.

A Peculiar Case of Iliac Vein Aneurysm

Venous abdominal aneurysm is a rare entity, especially at the iliac vein. This condition is very rare and is usually grave when the aneurysm ruptures. It requires immediate treatment, surgically or by endovascular technique, to prevent such complications. Most of the iliac vein aneurysm cases are associated with arteriovenous fistula (AVF). We report the case of a 33-year-old male who presented with iliac vein aneurysm secondary to AVF. He was treated surgically after a failed endovascular procedure. The venous aneurysm had numerous feeder vessels which were difficult to manage intraoperatively. It prompted us to ligate the common iliac artery and do grafting between the common iliac artery and the common femoral artery. Iliac vein aneurysm diagnosis requires precise clinical suspicion, and the treatment is based on patients' clinical presentation and radiological features. Use of appropriate imaging modalities facilitates a correct preoperative diagnosis which consequently improves the surgical outcome.

Repair of giant iliac vein aneurysm due to a chronic traumatic arteriovenous fistula of the thigh

Repair of giant iliac vein aneurysm due to a chronic traumatic arteriovenous fistula of the thigh

Iliac Vein Aneurysms: A Comprehensive Review

Introduction: Iliac vein aneurysm is a rare clinical entity. Iliac venous tract is the least commonlocation for venous aneurysms. There are a few cases of common, external and internal iliac veinaneurysms in the literature. However, undiagnosed and ruptured iliac venous aneurysms couldhave hazardous consequences. Herein, we reviewed all literature cases of iliac vein aneurysms.Their potential diagnostic and therapeutic challenges are discussed. Literature Review: Following a systematic search, 50 cases of iliac venous aneurysms wereidentified. We used MEDLINE [1900-March 2018] and EMBASE [until March 2018]. MeSHterms of iliac vein/veins/venous, hypogastric, inferior vena cava and aneurysm/aneurysms wereused. Fifty patients with venous aneurysms located in common, external or internal iliac veinswere found in our systematic search. Seventeen patients were female (35.4%) and 31 patients weremale (64.6%). The age range was 13 to 70 years of age. The aneurysm was located in right side in17 patients (34%). It was located in left side in 29 patients (58%) and it was bilateral in 4 patients(8%). The aneurysm was located in common, external and internal iliac veins in 15 (30%), 31(62%) and 4 (8%) patients respectively. The aneurysm was due to a previous arteriovenousfistula (AVF) in 19 patients (38%) and of them, 16 patients (32%) had a history of AVF resultingfrom a previous trauma. 29 patients (59.2%) underwent open surgical treatment. Five patients(10.2%) underwent endovascular treatment. One patient (2.0%) underwent hybrid treatment.Conservative treatment was used in 14 patients (28.6%). Conclusion: Iliac vein aneurysms are extremely rare. Its diagnosis necessitates precise clinicalsuspicion and the treatment is based on patients’ clinical scenario and radiological features. Bothopen and endovascular techniques could be feasible. Iliac vein aneurysms are more commonin men. Left sided aneurysms are more common. The most common anatomic location isexternal iliac vein. The most common cause of iliac aneurysms is dilatation of vein secondary toa traumatic AVF.

Repair of a large iliac vein aneurysm secondary to a high-flow pelvic arteriovenous malformation under deep hypothermic circulatory arrest

Repair of a large iliac vein aneurysm secondary to a high-flow pelvic arteriovenous malformation under deep hypothermic circulatory arrest

Iliac vein aneurysms: a comprehensive review.

Introduction: Iliac vein aneurysm is a rare clinical entity. Iliac venous tract is the least commonlocation for venous aneurysms. There are a few cases of common, external and internal iliac veinaneurysms in the literature. However, undiagnosed and ruptured iliac venous aneurysms couldhave hazardous consequences. Herein, we reviewed all literature cases of iliac vein aneurysms.Their potential diagnostic and therapeutic challenges are discussed. Literature Review: Following a systematic search, 50 cases of iliac venous aneurysms wereidentified. We used MEDLINE [1900-March 2018] and EMBASE [until March 2018]. MeSHterms of iliac vein/veins/venous, hypogastric, inferior vena cava and aneurysm/aneurysms wereused. Fifty patients with venous aneurysms located in common, external or internal iliac veinswere found in our systematic search. Seventeen patients were female (35.4%) and 31 patients weremale (64.6%). The age range was 13 to 70 years of age. The aneurysm was located in right side in17 patients (34%). It was located in left side in 29 patients (58%) and it was bilateral in 4 patients(8%). The aneurysm was located in common, external and internal iliac veins in 15 (30%), 31(62%) and 4 (8%) patients respectively. The aneurysm was due to a previous arteriovenousfistula (AVF) in 19 patients (38%) and of them, 16 patients (32%) had a history of AVF resultingfrom a previous trauma. 29 patients (59.2%) underwent open surgical treatment. Five patients(10.2%) underwent endovascular treatment. One patient (2.0%) underwent hybrid treatment.Conservative treatment was used in 14 patients (28.6%). Conclusion: Iliac vein aneurysms are extremely rare. Its diagnosis necessitates precise clinicalsuspicion and the treatment is based on patients’ clinical scenario and radiological features. Bothopen and endovascular techniques could be feasible. Iliac vein aneurysms are more commonin men. Left sided aneurysms are more common. The most common anatomic location isexternal iliac vein. The most common cause of iliac aneurysms is dilatation of vein secondary toa traumatic AVF.

External iliac vein aneurysm due to arteriovenous fistula between popliteal artery and popliteal vein-a rare entity.

External iliac vein aneurysm due to arteriovenous fistula between popliteal artery and popliteal vein-a rare entity.

Endovascular Treatment of a Large Iliac Vein Aneurysm and High-Flow Arteriovenous Fistula

Iliac arteriovenous fistulas (AVFs) are rare but can cause significant morbidity. This report illustrates the endovascular management of a patient with an iliac vein aneurysm caused by an AVF. A 35-year-old pregnant woman was found on routine ultrasound examination to have a left 4.5-cm aortoiliac aneurysm. Past medical history included anxiety, obesity, Lyme disease, methadone use, and hypothyroidism. In addition, she had four emergency department visits during a 2.5-year period leading to diagnoses of pulmonary hypertension (right ventricular pressure of 62 mm Hg) and high-output heart failure of unclear etiology requiring chronic diuresis. Her surgical history included lumbar disk surgery and two cesarean sections. She had no history of abdominal trauma. On examination, she had lower extremity swelling and a pulsating abdominal mass. Because of the high-risk nature of the pregnancy, elective termination was recommended and subsequently performed. Computed tomography angiography showed a left common iliac vein aneurysm measuring 5.5 × 4.2 cm (Fig) and a left common iliac artery to common iliac vein AVF with associated mega cava. The AVF was thought to be related to prior spine surgery. The patient underwent percutaneous endovascular repair of the AVF with placement of a bifurcated aortic AFX stent graft (Endologix, Irvine, Calif). As the AVF was close to the left iliac artery bifurcation, the left internal iliac artery was embolized with an Amplatzer plug (St. Jude Medical, St. Paul, Minn) and the stent graft extended to the left external iliac artery. Completion angiography showed resolution of the AVF. Recovery was uneventful, and the patient was discharged on a 3-month course of coumadin to prevent thrombosis. She had complete resolution of cardiopulmonary symptoms with a decrease in right ventricular pressure to 30 mm Hg at 2 months after the procedure. Computed tomography angiography at 6 months showed no evidence of AVF and shrinkage of the left iliac vein aneurysm to 2.5 cm (Fig). AVF can unusually present as a venous aneurysm. Endovascular treatment of the AVF can resolve the aneurysm and reverse systemic hemodynamic changes.

Tratamento cirúrgico de um aneurisma primário de veia ilíaca externa

ResumoAneurismas primários da veia ilíaca são extremamente raros e podem complicar com trombose, embolia pulmonar ou ruptura. Acredita-se que existam apenas 14 casos descritos na literatura. Neste artigo, descrevemos um caso de um jovem de 25 anos, que apresentava edema e cianose do membro inferior esquerdo. A ecografia vascular revelou uma massa cística em fossa ilíaca esquerda. A angiotomografia confirmou o diagnóstico de um aneurisma da veia ilíaca externa esquerda de 3,8 cm, no maior diâmetro. O paciente foi submetido ao tratamento cirúrgico através da ressecção do aneurisma seguida de venorrafia longitudinal. Teve boa evolução pós-operatória, com um seguimento clínico de 44 meses. Houve uma melhora do edema no membro inferior esquerdo, sem complicações tardias.

External iliac vein aneurysm as a cause of paradoxical embolism

Iliac vein aneurysms are rare, even among venous aneurysms. We report the first case of an external iliac vein aneurysm presenting with paradoxical embolism to bilateral lower extremities. Workup after embolectomy demonstrated a patent foramen ovale along with the aneurysm and an inferior vena cava obstruction, which was treated with balloon angioplasty and ultimately stenting. The patient then underwent interval lateral aneurysmectomy. At 4-year follow-up, she is free of recurrence.

Endovascular exclusion of a large external iliac vein aneurysm.

Iliac vein aneurysms are uncommon, and there is no consensus on optimal treatment. We present a case of venous exclusion using an endovascular approach. To our knowledge, this is the first reported case of a large external iliac vein aneurysm treated endovascularly. We have demonstrated the feasibility of this approach with satisfactory 1-year follow-up.

Novel Repair of an External Iliac Vein Aneurysm

Aneurysms involving the venous system are a rare entity. We report the case of a 37-year-old woman who presented to us with activity-limiting left gluteal pain and who on consequent workup was found to have a left external iliac vein aneurysm in a setting of iliocavomegaly. She underwent successful treatment of her aneurysm with a novel approach that involved staple plication and resection of the aneurysm over a balloon mandrel. We discuss the presentation, diagnosis, and surgical technique adopted for the treatment of this uncommon condition.

Asymptomatic Bilateral External Iliac Vein Aneurysms in a Young Athlete: Case Report and Literature Review

Iliac vein aneurysms are an exceedingly uncommon problem faced by vascular specialists. We report a case of a healthy 32 year old woman who had large asymptomatic bilateral external iliac vein aneurysms found incidentally on CT scan. They may present with thromboembolism, spontaneous rupture, or they may be asymptomatic. In evaluating these aneurysms, it is important to obtain volumetric imaging data that can be rendered in 3-dimensions and reconstructed in multiple planes. With our patient, it was the multiplanar reconstructions that best demonstrated the fusiform morphology of the aneurysms. Treatment for asymptomatic external iliac veins is controversial.

Staged Approach for Surgical Management of External Iliac Vein Aneurysm Associated With Traumatic Femoral Arteriovenous Fistula

Aneurysms of the iliac vein are rare. They can occur in association with arteriovenous fistulae located elsewhere. Here, we present a 30-year-old man who developed a large left external iliac vein aneurysm in association with a chronic traumatic arteriovenous fistula in the left thigh. Less than 25 cases of iliac vein aneurysms have been reported in the last 40 years. The presentation and treatment of this condition has been heterogeneous. We suggest that adequate surgical treatment can be offered in a staged approach: aneurysm resection with reconstruction should be done first, followed by closure of the arteriovenous fistula 6 months later.

Large external iliac vein aneurysm in a patient with a post-traumatic femoral arteriovenous fistula

We report about a young patient with a large aneurysm of the left external iliac vein associated with a traumatic arteriovenous fistula between the left superficial femoral artery and the femoral vein after a stab wound 20 years ago. The patient presented with swelling of the left leg, which developed during the past years and worsened after saphenectomy 12 months before hospital admission. The chronically hyperperfused common iliac artery proximal to the arteriovenous fistula was compressing the common iliac vein. The venous outflow obstruction and subsequent venous hypertension render a possible explanation for the formation of the iliac vein aneurysm. Surgical repair of the venous aneurysm by interposition grafting and closure of the arteriovenous fistula was successful. A postoperative computed tomography scan showed a 50% size reduction of the feeding artery, underlining the ability of the arterial system to normalize arterial diameter in response to flow reduction, even after a high flow situation had existed for probably >20 years.