c l i n i c a l f o l i o s : n a r r a t i v e





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Preoperative Issues in Aortic Surgery: CT Findings: 7

A D V E R T I S E M E N T

   
 

Another important anatomic feature in the CT scan is the status of the iliac arteries. Over ninety percent of iliac artery aneurysms are combined with an AAA either as a direct extension (fusiform aortoiliac) or coexistent. Conversely, about 10 -20% of aortic aneurysms have aneurysmal involvement of the iliac segments. Seventy percent of Iliac artery aneurysms involve the common iliac artery, with most others involving the internal. Isolated external iliac artery involvement is rare. Iliac artery aneurysms involve multiple segments in over one third of patients. Traditionally, 2.5-3.0 cm diameter has been the size considered for elective iliac artery aneurysm repair, based on minimal incidence of rupture below 3.5 cm. This CT scan demonstrates a left common iliac artery aneurysm (solid arrow) with a normal right common iliac artery (dashed arrow).   

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Preoperative Issues in Aortic Surgery: CT Findings: 8

A D V E R T I S E M E N T

   
 

Due to the limited space of the male pelvis, large iliac aneurysms can compress adjacent structures. Here the left ureter (solid arrow) is dilated due to compression from a large internal iliac aneurysm (dashed arrow).       

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Preoperative Issues in Aortic Surgery: CT Findings: 9

A D V E R T I S E M E N T

   
 

Venous anomalies are rare, but important to be aware of preoperatively. This CT scan demonstrates a retroaortic left renal vein (arrow). Intraoperative shot of the retroaortic left renal vein (arrow). If unaware, the surgeon can easily injure this vein with proximal clamp placement, resulting in major hemorrhage.      

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This page was last modified on 3/28/2001.