From the Guidelines
The right internal iliac artery measurement of 1.6 x 1 cm and left iliac artery measurement of 1.4 x 1.4 cm suggest the presence of iliac artery occlusive disease, which requires further evaluation and management to prevent complications such as claudication, limb ischemia, and potential rupture. Given the measurements, it is essential to consider the patient's symptoms, medical history, and risk factors for atherosclerosis, as outlined in the guidelines by 1. The patient's sedentary lifestyle and potential symptoms such as mild left lower-extremity claudication on walking, as mentioned in 1, should be taken into account when determining the best course of action. The guidelines recommend noninvasive screening with US and measurement of ABI or segmental arterial pressures in the outpatient clinic setting, as stated in 1. If findings suggest peripheral artery disease, further confirmation with CTA or MRA is usually required to determine the best application of endovascular or surgical intervention, as noted in 1. In terms of management, medical therapy, including risk factor modification, supervised exercise program, and antiplatelet therapies, should be considered, as recommended in 1 and 1. However, given the size of the right internal iliac artery, intervention may be necessary, and the patient should be referred to a vascular surgeon for further evaluation and management, as suggested by the guidelines in 1. The patient should also be advised to avoid strenuous activities that could increase blood pressure and to follow a supervised exercise program to improve symptoms, as recommended in 1 and 1. Regular follow-up imaging every 6-12 months is recommended to monitor the size of the iliac arteries and to assess for any changes or progression of disease, as implied by the guidelines in 1. Ultimately, the goal of management is to prevent complications, improve symptoms, and enhance quality of life, as emphasized in 1, 1, and 1.
From the Research
Measurements of Internal Iliac Arteries
- The right internal iliac artery measures 1.6 x 1 cm, while the left internal iliac artery measures 1.4 x 1.4 cm.
- According to a study published in 1994 2, the mean caliber of the common iliac arteries in healthy subjects was 8.8 mm, with a statistically significant difference between the right and left sides, where the right was larger than the left.
Comparison with Normal Values
- The study published in 1994 2 found that the vessel caliber of male subjects was larger than that of female subjects by a statistically significant margin.
- However, there is no direct comparison with the given measurements, as the study focused on the common iliac arteries, not the internal iliac arteries.
Clinical Significance
- Internal iliac artery stenosis is a condition that can cause lower extremity arterial disease (LEAD) 3.
- Compression of the iliac veins can also occur, with the right iliac vein being compressed by the right external iliac artery and the right internal iliac artery 4, or by the right internal iliac artery alone, as reported in a case study 5.
- The management of internal iliac artery aneurysms has been studied, with a proposed management strategy involving open surgery, endovascular repair, or both, depending on the circumstances of treatment 6.