Introduction and importance Abdominal aneurysms, often involving the iliac arteries, pose serious risks if untreated. Iliac arteriovenous fistulas (AVFs) are rare, typically secondary to trauma or deep vein thrombosis, with unclear mechanisms. They may present with high-output heart failure, abdominal bruits, and venous congestion. Computed tomography angiography (CTA) is essential for diagnosing aortoiliac aneurysms and fistulas. Endovascular repair, including recanalization and stenting, is the preferred approach …