Endovascular treatment of an isolated iliac artery aneurysm associated with segmental arterial mediolysis

Segmental arterial mediolysis is a noninflammatory nonatherosclerotic vasculopathy of uncertain etiology characterized by dissection and/or aneurysm formation. It affects medium-to-large arteries, primarily the celiac, superior mesenteric, and renal arteries. Iliac involvement rare, its specific treatment has not been described. We detail patient who presented with intrabdominal hemorrhage from ruptured right colic artery aneurysm. He underwent transcatheter embolization followed hemicolectomy. Histopathology confirmed diagnosis segmental mediolysis. Endovascular 3-cm iliac was performed 18 months later. There successful exclusion demonstrated on computed tomography angiography at 10 years.