Iliac artery aneurysms are most commonly associated with aortic aneurysms. Isolated iliac aneurysms are less common but are frequently bilateral at time of presentation. The incidence of metachronous iliac aneurysm formation is unknown. The authors present a case report of a patient with metachronous rupture of iliac aneurysms occurring 3 years apart. The presence of a unilateral iliac aneurysm should prompt close surveillance with computed tomography to identify metachronous lesions before they become symptomatic or rupture in order to decrease the morbidity and mortality associated with ruptured iliac aneurysms.
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