Unveiling the uncommon: hypoplasia of external iliac artery-a case report and literature review.

The absence or dysplasia of the iliac artery(IA) is an exceedingly rare condition, with limited cases documented in the literature. In this report, we present a case of hypoplasia of the right external iliac artery (EIA) in a 69-year-old male patient. The patient presented with right lower abdominal pain attributed to an aneurysm of the right internal iliac artery (IIA), yet notably, there was no evidence of lower limb ischemia at the time of consultation. Computed tomography angiography (CTA) of the aorta revealed a slender and occluded right EIA. Additionally, aneurysms were identified in the abdominal aorta (AA), the common iliac artery (CIA), and the right IIA, with collateral circulation involving the deep femoral artery and internal pathways. We performed aortoiliac aneurysm repair with a bifurcated synthetic graft on the patient's AA and iliac artery (IA), successfully excising the abdominal aorta aneurysms (AAA) and the CIA aneurysm. Postoperatively, thrombosis of the internal iliac aneurysm was observed, and the patient experienced a resolution of pain symptoms in the right lower abdomen. This paper delineates the vascular variations and treatment strategies employed and provides a review of the existing literature on IA malformations.