Maheshwari Naveen, Vaddavalli Venkata Vineeth, Abuji Kishore, Savlania Ajay, Nada Ritambhra
Post Graduate Institute of Medical Education and Research - PGIMER, Chandigarh, India.
J Vasc Bras. 2023 Apr 7;22:e20220119. doi: 10.1590/1677-5449.202201192. eCollection 2023.
Isolated external iliac artery aneurysm is a rare occurrence. These aneurysms have varied presentations depending on size and proximity. Both open surgical and endovascular modalities can be used for treatment depending upon presentation, aneurysmal anatomy, and patient condition. Preservation of at least one internal iliac artery is important to prevent post-repair hypogastric ischemia. There are no previous reports of IgG4-related disease (IgG4-RD) as etiology of these aneurysms. A 32-year-old male patient presented with a left lower abdominal lump and was found to have a left external iliac artery aneurysm on computed tomography angiography. The patient underwent iliofemoral bypass with an 8 mm polyester graft. Histopathological examination of the aneurysm wall suggested IgG4-RD. The patient fulfilled the 2020 Revised Comprehensive Diagnostic Criteria for IgG4-RD. An 18-Fluorodeoxyglucose-Positron Emission Tomography scan performed in the postoperative period showed no active disease, hence medical therapy was not instituted. The patient is doing well at 1 year.
孤立性髂外动脉瘤较为罕见。这些动脉瘤的表现因大小和位置而异。根据临床表现、动脉瘤解剖结构和患者情况，开放手术和血管内治疗方式均可用于治疗。保留至少一条髂内动脉对于预防修复后下腹缺血很重要。此前尚无关于IgG4相关疾病（IgG4-RD）作为这些动脉瘤病因的报道。一名32岁男性患者因左下腹部肿块就诊，计算机断层血管造影显示左髂外动脉瘤。患者接受了8毫米聚酯移植物的髂股旁路移植术。动脉瘤壁的组织病理学检查提示IgG4-RD。该患者符合2020年修订的IgG4-RD综合诊断标准。术后进行的18氟脱氧葡萄糖正电子发射断层扫描显示无活动性疾病，因此未进行药物治疗。患者术后1年情况良好。
