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Isolated iliac artery aneurysms are rare lesions that are difficult to detect and treat. Prompt diagnosis and timely intervention are essential, because the incidence of rupture is as high as 50%. The reported mortality rate for patients who undergo surgery for ruptured iliac artery aneurysm ranges from 50% to 70%. The recommended therapy remains surgical excision, although percutaneous techniques are effective alternatives in selected cases. Early intervention, carried out in a systematic fashion, can reduce the high morbidity and mortality.