Endovascular Repair of a Giant Inferior Mesenteric Artery Aneurysm

Inferior mesenteric artery (IMA) aneurysms are rare visceral artery aneurysms. We present a 65-year-old man with multiple comorbidities who presented with rectal bleeding and was found to have a 7-cm IMA aneurysm with an associated IMA–IMV arteriovenous fistula. Given the aneurysm size and rupture risk, the patient underwent successful endovascular coil embolization with complete occlusion of the aneurysm and fistula on completion angiography. This case highlights the rare coexistence of an IMA aneurysm and an IMA–IMV AVF, for which the temporal and causal relationship remains uncertain, and supports the efficacy of endovascular coil embolization in high-risk patients.