Endovascular Repair of an Abdominal Aortic Aneurysm with Iliac Vein Compression Syndrome

Abstract

An 84-year-old man with chronic obstructive pulmonary disease (COPD) was referred to our institution for further treatment of severe swelling of the left lower extremity. The left iliac vein was compressed by the abdominal aortic aneurysm and a right common iliac arterial aneurysm measuring 62 mm and 45 mm in diameter and was partially thrombosed. Multiple pulmonary artery embolisms were also noted. Endovascular repair of the abdominal aortic aneurysm and the right common iliac arterial aneurysm was performed because of his respiratory dysfunction. The left leg edema gradually resolved after endovascular treatment. Six months after the treatment, computed tomography (CT) demonstrated resolution of the venous thrombus of the left lower extremity. Although open surgery is reliable treatment for iliac compression syndrome, endovascular treatment might be a feasible and an adequate therapeutic option for patients who have severe comorbidities, complications, or high frailties.

Keywords: abdominal aortic aneurysm; endovascular aneurysmal repair; iliac vein compression syndrome.

Fig. 1. (a) Computed tomography demonstrated left iliac vein compressed by right common iliac aneurysm measuring 45 mm in diameter. (b) Thrombosis from left femoral vein to left iliac were detected (arrowheads). (c) Pulmonary thrombus was also detected (arrowheads).

Fig. 2. (a) CT performed 1 after treatment demonstrated decompression of left iliac vein. Common iliac aneurysmal diameter was unchanged compared with preoperative CT findings. (b) The venous thrombus of the left lower extremity was resolved. CT: computed tomography