A Case of Open Surgery for Bilateral Internal Iliac Artery Aneurysms Complicated with Urinary Retention and Constipation

Abstract

An 80-year-old man who had a history of myocardial infarction presented with urinary retention and persistent constipation when he was treated for congestive heart failure in our hospital. Computed tomographic angiography revealed bilateral giant internal iliac artery aneurysms (IIAs) compressing the rectum. We considered endovascular aneurysm repair (EVAR) as a treatment option. However, the reduction of the aneurysms volume might be inadequate to improve the symptoms. Thus, we performed graft replacement of the abdominal aorta and bilateral external iliac arteries, resection of the bilateral IIAs, and reconstruction of the internal mesenteric artery. He had good control of urination and defecation after surgery. His postoperative course was uneventful. Although the use of EVAR as a surgical treatment of abdominal aortic aneurysms and iliac artery aneurysms has become widespread, traditional open surgery should remain the gold standard treatment for symptomatic iliac artery aneurysms.