Management of Ruptured Isolated Aneurysms of the Iliac Artery

(Cardiovascular Center, Yokohama City University Medical Center, Yokohama, Japan and First Department of Surgery, Yokohama City University School of Medicine*, Yokohama, Japan)

Michio Tobe Jiro Kondo Kiyotaka Imoto
Shinichi Suzuki Susumu Isoda Naoki Hashiyama
Yoshimi Yano* Yoshinori Takanashi*
Fourteen patients with 22 solitary aneurysms of the iliac artery were operated in a 16-year period (1983 to 1999). Patients were divided into two groups. The non-ruptured group consisted of 6 patients who underwent surgical intervention before aneurysm rupture, and their mean age was 78.5 years. The ruptured group consisted of 8 patients who underwent surgical intervention for aneurysm rupture, with a mean age of 68.5 years. Although seven patients underwent emergency surgery for aneurysm rupture, less than half of them were operated upon within 24 hr after the onset of aneurysm rupture. The average size of aneurysms was similar in the two groups (common iliac artery aneurysms: non-ruptured 47 mm vs. ruptured 44mm in diameter, internal iliac artery aneurysms: non-ruptured 55mm vs. ruptured 55mm). Two patients died in the ruptured group, in which the operative mortality rate was 25%. Six patients (75%) of the ruptured group had hypovolemic shock, and two of them died during surgical repair. Of the patients with shock, two patients had intestinal ischemia after operation. Intestinal ischemia was one of the serious complications of ruptured iliac aneurysms. These results suggest that in patients with shock from ruptured iliac artery aneurysms, strategy for treatment is an important determinant of the outcome.
@Jpn. J. Cardiovasc. Surg. 30: 118-121(2001)