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A distinguished case of a spontaneously dissecting Left Common Iliac Artery Aneurysm, associated with an Elastinopathy, in a healthy 36-year-old male, successfully treated with open surgical repair - A Case Report

Omar K. Hariri,Omar Al Laham,A. Mohammad

Published 2022 in International journal of surgery case reports

ABSTRACT

Introduction and importance Elastin is a major protein of the Extracellular Matrix (ECM), essential in providing elasticity to the vascular wall, which enables blood vessels to reversibly expand and contract. Several inherited or acquired etiologies, such as elastinopathies and fibrillinopathies negatively impact the objective of the Extracellular Matrix via compromising the Elastin fibers in the Cardiovascular System (CVS) and the skin. Such compromises will have devastating ramifications through the increase in vascular wall stiffness and the inability to properly dissipate energy. This impact on the vascular wall will contribute to the development of arterial aneurysms and dissections. Case presentation Our case is of a 36-year-old previously healthy male patient who presented with an acute onset of left lower limb pain associated with cold sensation two days prior to admission. Radiology demonstrated a dissecting aneurysm in the left Common Iliac Artery. Clinical discussion The patient was surgically treated with an Aorto-bi-Femoral Bypass (ABFB). Histopathological analysis of the excised aortic and iliac specimens revealed no Elastin fibers in the vessel walls. Conclusion Isolated Iliac aneurysms are a rare entity and are challenging to diagnose preoperatively. In our case, there were no risk factors whatsoever and the patient's history - including family history - was negative. It is vital to establish preoperative diagnostic approaches in such cases and keep them in mind so that we can diminish the morbidity and mortality resultants from the complications.

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