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Review
. 2024 May 15;13(10):2909.
doi: 10.3390/jcm13102909.

Percutaneous Retrograde Trans-Gluteal Embolization of Type 2 Endoleak Causing Iliac Aneurysm Enlargement after Endovascular Repair: Case Report and Literature Review

Andrea Esposito  1 , Rocco Pasqua  1   2 , Danilo Menna  1 , Antonio Nicola Giordano  1 , Giulio Illuminati  2 , Vito D'Andrea  2
Affiliations
Review

Percutaneous Retrograde Trans-Gluteal Embolization of Type 2 Endoleak Causing Iliac Aneurysm Enlargement after Endovascular Repair: Case Report and Literature Review

Andrea Esposito et al. J Clin Med. .

Abstract

Late type II endoleaks (T2ELs) arising from the internal iliac artery (IIA) may present during follow-up after endovascular aortic repair (EVAR) of aortoiliac aneurysm and may warrant embolization if enlargement of the aneurysmal sac is demonstrated. When coverage of the IIA ostium has been made due to extensive iliac disease, access options can be challenging. Different treatment options have been reported over recent years, and a careful selection of the best one must be made based on the characteristics of each case. The present study reports a simple and reproducible sheathless percutaneous superior gluteal artery (SGA) access and provides a discussion based on a review of the existing literature on this topic.

Keywords: embolization; endoleak; endovascular aortic repair; endovascular technique; internal iliac artery; superior gluteal artery.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Enhanced computed tomography scan showing the left common iliac artery aneurysm after coil embolization and external iliac extension (A) and its enlargement with late contrast phase endoleak at 3-year follow-up (B).
Figure 2
Figure 2
Intraoperative angiography through the left hypogastric artery showing the common iliac artery aneurism nidus of the endoleak (A), coil embolization with embolizing liquid agent (B), and completion angiography with no further nidus visualization (C).
Figure 3
Figure 3
One-year enhanced CT scan showing left common iliac artery aneurysmatic sac stability and no endoleaks during the late contrast phase.
See this image and copyright information in PMC

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