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. 2022 Mar 25;15(1):45-48.
doi: 10.3400/avd.cr.21-00019.

Internal Iliac Artery Aneurysm Ruptures with No Visualized Endoleak 2 Years after Endovascular Repair

Ayumi Harada  1 , Koichi Morisaki  1 , Shun Kurose  1 , Shinichiro Yoshino  1 , Sho Yamashita  1 , Tadashi Furuyama  1 , Masaki Mori  1
Affiliations

Internal Iliac Artery Aneurysm Ruptures with No Visualized Endoleak 2 Years after Endovascular Repair

Ayumi Harada et al. Ann Vasc Dis. .

Abstract

We report a case of an 83-year-old man with a ruptured internal iliac artery (IIA) aneurysm after endovascular repair, which was treated via the ligation of IIA and tight suture of the aneurysm sac. Although there were no findings of obvious endoleak after endovascular treatment, the IIA aneurysm increased in size and eventually ruptured. We presumed that pressure to IIA aneurysm via the embolized IIA led to rupture. Aneurysm sac expansion may lead to a rupture despite no endoleak being detected; therefore, close follow-up or re-intervention must be considered. Tight embolization of IIA may prevent endotension in the same case.

Keywords: endotension; endovascular repair; isolated internal iliac artery aneurysm.

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Conflict of interest statement

Disclosure StatementThe authors declare no potential conflicts of interest concerning the research, authorship, and/or publication of this article.

Figures

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Fig. 1 (A), (B) Computed tomography (CT) showing a 36 mm right internal iliac artery (IIA) aneurysm. (C) Preoperative angiography showed IIA aneurysm. (D) Angiography at initial treatment after IIA embolization and stent graft placement showed no endoleak. (E), (F) The right IIA aneurysm was treated by IIA embolization and stent graft placement. CT 5 days after endovascular treatment showed no obvious endoleak.
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Fig. 2 (A), (B) Computed tomography 2 years after endovascular treatment showing a 50 mm right internal iliac artery aneurysm with no obvious endoleak. (C) Angiography showed no findings of endoleak 2 years after endovascular repair.
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Fig. 3 (A), (B) Computed tomography showing a ruptured internal iliac artery aneurysm (arrow) and a large hematoma around the aneurysm (arrowheads).
See this image and copyright information in PMC

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