ABSTRACT
PURPOSE: To report a collateral pathway involving the deep circumflex iliac artery causing a type II endoleak following endoluminal exclusion of an abdominal aortic aneurysm (AAA). CASE REPORT: A 75-year-old man was investigated for a persistent type II endoleak 2 years after endovascular AAA repair with a Zenith Trifab stent-graft. Angiography revealed contrast in the sac from a lumbar artery fed via a collateral of the deep circumflex iliac artery. The lumbar artery was embolized with coils, but an endoleak persisted and is being followed. CONCLUSIONS: This collateral pathway is easily missed during angiography for endoleaks and should be considered where an endoleak is suspected but cannot be found.
Subject(s)
Aortic Aneurysm, Abdominal/surgery , Iliac Artery , Postoperative Complications , Aged , Angiography, Digital Subtraction , Aortic Aneurysm, Abdominal/diagnostic imaging , Blood Vessel Prosthesis Implantation , Collateral Circulation , Humans , Iliac Artery/diagnostic imaging , Male , StentsABSTRACT
PURPOSE: To review the clinical features and management of spontaneous iliac dissections. CASE REPORT: A healthy 60-year-old competitive cyclist presented with acute onset of short-distance claudication following vigorous exercise. Angiography showed a dissection flap extending from the right common iliac artery to the external iliac artery. An uncovered stent was placed across the proximal entry site but did not obliterate the false lumen; open surgical intervention was required. CONCLUSIONS: Spontaneous dissection of the iliac artery is a rare but important condition to suspect in high performance athletes complaining of leg pain following exercise.
