A disease in which a part of the blood vessel that delivers oxygen-rich blood to the lower part of the body is weakened is called an iliac artery aneurysm. Usually, it causes the stretched part to press against nearby tissues and structures, leading to symptoms. When an aneurysm breaks, it is considered a medical emergency.
In other words, an iliac artery aneurysm is a rare bulging or stretching of a weak part of the iliac artery wall localized in the pelvic area. It is located below the waist and delivers blood from the aorta to the lower part of the body. Usually, a rupture of the iliac artery is prevented or repaired with surgery.
What Are The Symptoms of an Iliac Artery Aneurysm?
While some people do not experience any symptoms, others may notice the following symptoms. Check some examples below:
- Tenesmus (urge to urinate or poop, but nothing coming out)
- Constipation
- Sudden pain that occurs in the abdomen (belly), flank, or groin
- Nerve disease caused by pressure on nerves
- Swelling in the affected leg
- Difficulty urinating because the aneurysm puts pressure on the ureter (the tube that carries urine from the kidney to the bladder)
- Pelvic, back, or rectal pain
Immediately contact your healthcare provider if any of the symptoms listed above occur. Leaving this condition untreated may lead to serious complications.
Causes and Risk Factors
There are different causes of an iliac artery aneurysm. Check the most common of them below:
- Atherosclerosis (plaque buildup on the arteries)
- Pregnancy
- Bacterial infections
- Injury from surgery
While anyone can develop this condition, some factors could elevate your risk. Examples include:
- Medical history of infection or trauma
- A family history of aneurysm or dissections
- Sex – Iliac artery aneurysms tend to occur in males more frequently.
- Age – Most diagnosed cases are in people over 60 years old. However, it still may occur at any age.
- Hypertension (high blood pressure)
- Hyperlipidemia (high cholesterol)
- Misuse of tobacco products (including smoking cigarettes)
What Are The Potential Complications of an Iliac Artery Aneurysm?
Those who ignore the symptoms and do not get treatment may experience some complications. Check some examples below:
- Aneurysm rupture – This is a serious complication that requires immediate medical attention. Otherwise, it may lead to internal bleeding into the abdomen or pelvic area, which may cause fatal shock.
- Thrombosis – It occurs when blood clots form inside the weak or stretched artery sac.
- Embolism – In this case, small clots or plaques break off and travel to the legs or feet.
- Acute limb ischemia – It happens when sudden loss of blood flow to a leg causes severe pain, coldness, and tissue death.
- Ureteral obstruction – This complication occurs when the bulging artery puts pressure on the tube that goes from the kidney.
- Nerve pressure – It may also cause deep back, hip, or groin pain.
- Vein blockage – Sometimes, the bulging artery puts pressure on major veins, which may cause deep vein thrombosis (DVT) or severe leg swelling.
- Bowel or bladder problems – These include constipation, difficulty emptying the bladder, and others.
The previous list does not contain all possible complications. In any case, you can consult with your physician about ways to reduce the risk or even prevent the previous complications.
Is There a Way to Prevent an Iliac Artery Aneurysm?
While it is not always possible to prevent this condition, doctors may recommend some options to reduce the risk. Examples include:
- Manage chronic health conditions – For example, hyperlipidemia, diabetes, hypertension, and others.
- Stop smoking – If you have problems with smoking cessation, discuss it with your doctor.
- Limit or avoid alcoholic beverages
- Regularly perform physical activity – You should aim for 30 minutes of physical exercise per day, at least 5 days a week to get or maintain a healthy weight.
Diagnosis
In most cases, the diagnosis of an iliac artery aneurysm starts with a physical examination in which doctors look for irregularities linked to the disease. They may also ask some questions about the symptoms and medical history to get more information about your disease. However, to confirm or exclude an iliac artery aneurysm, they will perform some imaging tests. These include ultrasound and CT (computerized tomography) angiogram.
Treatment
When an aneurysm is small, people do not need treatment. However, doctors recommend regular checkups each year to monitor the aneurysm. During this time, they will recommend lifestyle changes to manage the condition. If an aneurysm grows larger than 1 inch (about 3 centimeters), you may need surgery to repair it. Sometimes, doctors may repair this problem with minimally invasive surgery, but it is not an option for everyone. Typically, physicians perform open surgery and repair the weakened wall of the iliac artery. They often use a fabric graft to strengthen or replace the affected part.
Frequently Asked Questions
What is an iliac artery aneurysm?
An iliac artery aneurysm is an abnormal bulge or enlargement in a weakened area of an iliac artery, which carries blood from the aorta into the pelvis and legs. It can occur in one or both iliac arteries and may not cause symptoms until it becomes large or causes complications.
Is an iliac artery aneurysm dangerous?
An iliac artery aneurysm can be dangerous, particularly if it becomes large, forms a blood clot, blocks blood flow, or ruptures. A rupture can cause severe internal bleeding and may be life-threatening, so sudden severe abdominal, pelvic, back, flank, or groin pain requires immediate medical attention.
What causes an iliac artery aneurysm?
Atherosclerosis is one possible cause, but aneurysms may also develop because of inherited weaknesses in the artery wall, infections, trauma, inflammation, or previous vascular procedures. Sometimes, doctors cannot identify the exact cause.
Who is most likely to develop an iliac artery aneurysm?
Iliac artery aneurysms are more common in older adults and occur more often in men. Risk may also increase with high blood pressure, high cholesterol, smoking, atherosclerosis, a personal or family history of aneurysms, and certain connective tissue or vascular disorders.
Can an iliac artery aneurysm cause leg pain?
Yes, an iliac artery aneurysm can cause leg pain if it reduces blood flow or if a blood clot or piece of plaque travels into an artery supplying the leg. Sudden severe leg pain accompanied by a cold, pale, numb, or weak leg can indicate acute limb ischemia and requires emergency medical care.
How is an iliac artery aneurysm diagnosed?
Doctors may use imaging tests to identify and measure an iliac artery aneurysm. Ultrasound can sometimes detect an aneurysm, while CT angiography provides detailed images of the blood vessels and can help determine its size, location, and relationship to nearby structures.
Does every iliac artery aneurysm require surgery?
Small aneurysms that do not cause symptoms may be monitored with regular imaging rather than repaired immediately. Treatment decisions depend on factors such as the aneurysm’s size, growth rate, location, symptoms, overall health, and risk of rupture.
What treatments are available for an iliac artery aneurysm?
Treatment may include regular monitoring and management of cardiovascular risk factors for smaller aneurysms. Larger, rapidly growing, symptomatic, or ruptured aneurysms may require repair. Depending on the person’s anatomy and health, repair may be performed through open surgery or an endovascular procedure using a stent graft.
Can an iliac artery aneurysm rupture?
Although rupture is uncommon, it is one of the most serious complications. A ruptured aneurysm can cause significant internal bleeding and shock. Sudden, severe abdominal, pelvic, back, flank, or groin pain, especially with weakness, dizziness, fainting, or low blood pressure, requires emergency medical treatment.
Can lifestyle changes prevent an iliac artery aneurysm from getting worse?
Healthy lifestyle choices may help reduce cardiovascular risk and protect blood vessels, although they cannot guarantee that an aneurysm will stop growing. Quitting smoking, controlling blood pressure and cholesterol, managing diabetes, maintaining a healthy weight, exercising regularly as advised by a healthcare professional, and attending recommended imaging appointments can be beneficial. Ask your doctor if you have any other questions.
