title: Secondary rupture of an iliac artery aneurysm after exclusion-bypass.
abstract: We report a case of secondary rupture of a common iliac artery aneurysm into the common iliac vein. Exclusion of the iliac aneurysm had been performed 2 years earlier in association with reconstruction of an aortic aneurysm that had ruptured into the interior vena cava. After closure of the aortocaval fistula by the endoaneurysmal route, aortobifemoral bypass grafting had been performed and a caval clip had been placed. The common iliac arteries had been sutured by the endoaneurysmal route and the right common iliac artery had been excluded by ligation of the right iliac artery. Occlusion of the interior vena cava distal to the caval clip resulted in increased peripheral venous hypertension causing the secondary arteriovenous fistula (rupture of scrotal varices and edema of lower extremities) but prevented right cardiac insufficiency. This observation confirms the possibility of secondary rupture after treatment of an aneurysm by exclusion. Thus the inclusion-graft technique is more reliable.
authors.affiliation: Service de Chirurgie Vasculaire, Centre Hospitalier et Universitaire de Nice, France.
authors.forename: M
authors.initials: M
authors.lastname: Batt
authors.forename: A
authors.initials: A
authors.lastname: Rogopoulos
authors.forename: H
authors.initials: H
authors.lastname: Bariseel
authors.forename: G
authors.initials: G
authors.lastname: Avril
authors.forename: R
authors.initials: R
authors.lastname: Hassen-Khodja
authors.forename: S
authors.initials: S
authors.lastname: Declemy
authors.forename: P
authors.initials: P
authors.lastname: Le Bas
mesh_terms: D000368:Aged; D017542:Aneurysm, Ruptured / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery; D001019:Aortic Rupture / Q000601:surgery; D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D006801:Humans; D017543:Iliac Aneurysm; D007083:Iliac Artery; D007084:Iliac Vein; D008297:Male; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D011859:Radiography; D012422:Rupture, Spontaneous; D013927:Thrombosis / Q000209:etiology; D014682:Vena Cava, Inferior