Hemodynamic changes after artificial vessel reconstruction for common iliac artery aneurysm: a case report

Objectives Isolated iliac artery aneurysms (IIAA) frequently coexist with abdominal aortic aneurysms (AAA), yet their causal association remains unclear. This study aimed to investigate hemodynamic alterations following artificial vessel reconstruction for iliac aneurysm and its impact on the abdominal aorta and iliac artery. Case presentation A 54-year-old man with a history of thyroid adenoma presented with left lower abdominal pain. Computed tomography angiography (CTA) revealed an aneurysm involving the entire left common iliac artery (48 mm × 55 mm × 81 mm). The patient was hemodynamically stable, with unremarkable physical examination and laboratory findings. He underwent aneurysm resection and aortoiliac reconstruction with a synthetic graft. Intraoperatively, arterial tortuosity and marked dilation at the bifurcation were noted. Postoperative CTA confirmed graft patency, and the patient recovered uneventfully. Preoperative and postoperative CTA scans were used for three-dimensional vascular reconstruction, followed by computational fluid dynamics (CFD) to assess hemodynamic parameters including wall shear stress (WSS), blood pressure, and flow velocity. Conclusion Prosthetic vascular reconstruction for common iliac artery aneurysm (CIAA) may produce dual hemodynamic effects on the abdominal aorta. While the causal link between CIAA and AAA is unproven, the surgery eliminates rupture risk of the target aneurysm. These exploratory results may provide hemodynamic references to optimize surgical planning for iliac artery aneurysms.