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Case Reports
. 2019 Jan 24;90(1):122-126.
doi: 10.23750/abm.v90i1.6605.

Endovascular repair of an abdominal aortic aneurysm using bifurcated stent-graft in a patient with bilateral external iliac artery occlusion

Bilal Nabulsi  1 , Claudio Bianchini Massoni, Tiziano Tecchio, Alessandro Ucci, Giulia Rossi, Paolo Perini, Matteo Azzarone, Alessandro De Troia, Antonio Freyrie
Affiliations
Case Reports

Endovascular repair of an abdominal aortic aneurysm using bifurcated stent-graft in a patient with bilateral external iliac artery occlusion

Bilal Nabulsi et al. Acta Biomed. .

Abstract

Abdominal aortic aneurysm (AAA) in association with external iliac artery (EIA) occlusion is a rare entity which may limit endovascular aortic aneurysm repair (EVAR) feasibility. We describe the case of an 84-year-old man affected by a 64mm infrarenal inflammatory abdominal aortic aneurysm with complete bilateral occlusion of EIA and patency of both common and internal iliac arteries. The common femoral arteries (CFA) were patent, and the patient was asymptomatic for lower limb claudication. The treatment was performed by EVAR using a bifurcated stent-graft after the recanalization of the left EIA, achieving technical success.

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Figures

Figure 1.
Figure 1.
Preoperative computed tomography angiography (CTA). A: Infrarenal inflammatory aneurysm. B: Multiplanar reconstruction showing the patency of both common iliac and hypogastric artery and the occlusion of external iliac artery
Figure 2.
Figure 2.
Recanalization of left external iliac artery. A: Diagnostic angiography. B: Predilation of the left external iliac artery with 4x120mm;7x40mm balloon C: Completion angiography
Figure 3.
Figure 3.
Dilation the left external iliac artery using 16Fr sheath introducer dilators (Cook Medical Inc)
Figure 4.
Figure 4.
Completion angiography shows patency of the endograft and both hypogastric iliac arteries
Figure 5.
Figure 5.
Computed tomography angiography performed 7 days after the operation. A: Maximum intensity projection reconstruction showing stent-grafts and extensive calcification of iliac axes. B: Axial image showing type II endoleak from lumbar arteries.
See this image and copyright information in PMC

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