RESUMEN
The patient, a 80-year-old man, had undergone aneurysmectomy and graft replacement of the right external iliac artery aneurysm and coil embolization and exclusion of the right internal iliac artery aneurysm in 2007. Computed tomography showed a rupture of the right internal iliac artery aneurysm in 2010. We performed aneurysmectomy and occlusion of the gluteal artery. The patient had a satisfactory postoperative course.
RESUMEN
To report endovascular occlusion of an internal iliac artery aneurysm (IIAA) of two patients using Amplatzer vascular plug (AVP; AGA Medical Corporation, USA). A 69-year-old asymptomatic man had aneurysms of both internal iliac arteries. The size of the right (Rt) IIAA was 23 mm and that of the left (Lt) IIAA was 45 mm. We decided to induce vascular occlusion of the Lt internal iliac artery (IIA). We deployed an AVP in the proximal and distal Lt IIA. The patient was discharged after four days and showed no recurrence of aneurysm for one year. A 78-year-old women had lower abdominal pain for three days. Computed tomography scan showed a 43 mm Rt common iliac artery (CIA) aneurysm and a 38 mm Rt IIAA. We decided to insert a stent graft in the Rt CIA and to occlude the Rt IIA using AVP. We deployed the stent graft in the Rt CIA and the AVP in the distal Rt IIA. The patient was discharged after seven days and demonstrated no recurrence of aneurysm for four months. AVP is a feasible vascular occlusive device for internal iliac artery aneurysm.
Asunto(s)
Anciano , Femenino , Humanos , Dolor Abdominal , Aneurisma , Arteria Ilíaca , Recurrencia , Stents , TrasplantesRESUMEN
A 90-year-old man was referred to our hospital for lower abdominal pain and ecchymotic discoloration around the anus. A laboratory test revealed severe anemia (hemoglobin level, 5.7 g/dl), and computed tomography (CT) showed a ruptured left internal iliac artery aneurysm (diameter, 60×44 mm). Consequently, emergency endovascular stent-grafting treatment was performed. Under local anesthesia, the stent-graft was successfully inserted in the left common and external iliac arteries, covering the ostia of the internal iliac artery. A follow-up CT scan showed complete thrombosis of the left internal iliac artery aneurysm and no evidence of an endoleak. After the procedure, the patient was treated with hemodialysis for acute-on-chronic renal failure and was discharged after 2 months.
RESUMEN
This report describes the open surgical or endovascular treatment of two patients with bilateral internal iliac artery aneurysms (IIAA). To prevent pelvic ischemia, complete aneurysmal resection and pelvic revascularization with an interposition graft was performed in the open surgical case. Endovascular repair including coil embolization of IIAA and stent-graft placement in the common iliac artery was done successfully in the other case. The contralateral IIAA was left undisturbed and followed for 36 months with no change in size. Prevention of pelvic ischemia is important in the simultaneous treatment of bilateral IIAA.