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Case Reports
. 2018 Feb 24;4(1):45-49.
doi: 10.1016/j.jvscit.2017.12.007. eCollection 2018 Mar.

Successful percutaneous transgluteal embolization of a complex arteriovenous malformation feeding a hypogastric artery aneurysm

Matteo Ripepi  1 , Gianfranco Varetto  1 , Lorenzo Gibello  1 , Maria Antonella Ruffino  2 , Paolo Fonio  2 , Pietro Rispoli  1
Affiliations
Case Reports

Successful percutaneous transgluteal embolization of a complex arteriovenous malformation feeding a hypogastric artery aneurysm

Matteo Ripepi et al. J Vasc Surg Cases Innov Tech. .

Abstract

Pelvic arteriovenous malformation (AVM) is a rare condition mostly requiring a complex therapeutic strategy. The surgical approach is challenging and burdened by relatively high mortality and morbidity rates. No guidelines are available for the endovascular treatment of AVM because the literature is limited to small case series and case reports. We present a complex case of a pelvic AVM associated with an internal iliac artery aneurysm in a patient previously treated with a common to external prosthetic substitution for aneurysm and proximal ligation of internal iliac artery.

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Figures

Fig 1
Fig 1
A-C, Computed tomography axial scans show a pelvic arteriovenous malformation (AVM) feeding a hypogastric artery aneurysm (HAA). D, Three-dimensional reconstruction of the pelvic AVM.
Fig 2
Fig 2
A and B, A posterior-anterior view of aortic angiogram shows hypertrophic right lumbar arteries and ipsilateral inferior epigastric artery feeding the arteriovenous malformation (AVM). C and D, Oblique views: hypertrophic contralateral hypogastric branches feeding the AVM. The arrow indicates the right external gluteal artery arising from the hypogastric aneurysm.
Fig 3
Fig 3
A and B, Diagrams showing placement of the patient and vascular percutaneous accesses at the beginning of the procedure and after repositioning. 1, Left jugular access. 2, Direct transgluteal access. 3, Left common femoral artery access. 4, Arteriovenous malformation (AVM) localization.
Fig 4
Fig 4
A-C, Intraoperative angiograms showing (A) direct puncture of the right gluteal artery, (B) inflation of an occlusion balloon in the right internal iliac vein, and (C) final control demonstrating complete exclusion of the arteriovenous malformation (AVM) and right hypogastric artery aneurysm (HAA) with coils and glue. D, Six-month three-dimensional reconstruction of computed tomography images showing the absence of hypogastric aneurysm reperfusion or recurrence of AVM.
See this image and copyright information in PMC

References

    1. Nakad G., AbiChedid G., Osman R. Endovascular treatment of major abdominal arteriovenous fistulas: a systematic review. Vasc Endovascular Surg. 2014;48:388–395. - PubMed
    1. Gandini R., Angelopoulos G., Konda D., Messina M., Chiocchi M., Perretta T. Transcatheter embolization of a large symptomatic pelvic arteriovenous malformation with Glubran 2 acrylic glue. Cardiovasc Intervent Radiol. 2008;31:1030–1033. - PubMed
    1. Do Y.S., Kim Y.W., Park K.B., Kim D.I., Park H.S., Cho S.K. Endovascular treatment combined with embolosclerotherapy for pelvic arteriovenous malformations. J Vasc Surg. 2012;55:465–471. - PubMed
    1. Char D., Ricotta J.J., Ferretti J. Endovascular repair of an arteriovenous fistula from a ruptured hypogastric artery aneurysm—a case report. Vasc Endovascular Surg. 2003;37:67–70. - PubMed
    1. Game X., Berlizot P., Hassan T., Joffre F., Chokairi S., Houlgatte A. Congenital pelvic arteriovenous malformation in male patients: a rare cause of urological symptoms and role of embolization. Eur Urol. 2002;42:407–412. - PubMed

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