A 75-year-old man was admitted with left lower limb weakness with findings of left isolated external iliac artery aneurysm and left hydronephrosis. Doppler ultrasound and contrasted computed tomography scan demonstrated a large 18 cm iliac artery aneurysm. Endoaneurysmorrhaphy and iliofemoral bypass were performed. The patient was well and discharged 2 weeks after operation. The incidence, natural history, and management of isolated iliac artery aneurysms are discussed and the literature is reviewed.
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