Endovascular treatment of ruptured iliac aneurysm previously treated by endovascular means.
A patient with a ruptured iliac aneurysm was admitted to the Emergency Department in hypovolemic shock. He had previously undergone surgical treatment for an infrarenal abdominal aortic aneurysm, which was managed with a terminal-terminal Dacron tube graft. Subsequently, he developed two iliac aneurysms, which were treated endovascularly with two wall-grafts in the right and one wall-graft in the left iliac arteries. He suffered chronic renal failure and arterial hypertension. Contrast-enhanced computed tomography showed rupture of the right iliac aneurysm and dislocation of the two wall-grafts. He was treated in an emergency situation with the implantation of an iliac endograft that bridged the two wall-grafts, which resulted in hemostasis and stabilization of his condition. Five days later, in an elective surgical situation, he was treated with the implantation of an aorto-uni-iliac endograft combined with a femoral-femoral bypass. He was discharged 5 days later in good condition. At the 4 year follow-up visit, the endoprosthesis remained in place with no evidence of an endoleak. In conclusion, overlapping of endografts should be avoided, if possible. Strict surveillance of the endovascularly treated patient remains mandatory.
Dalainas
Ilias
I
1st Unit of Vascular Surgery, Policlinico San Donato, University of Milan, Milan, Italy. hdlns@freemail.gr
Nano
Giovanni
G
Stegher
Silvia
S
Bianchi
Paolo
P
Malacrida
Giovanni
G
Tealdi
Domenico G
DG
D000368:Aged; D017542:Aneurysm, Ruptured / Q000000981:diagnostic imaging / Q000628:therapy*; D000792:Angiography; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D003287:Contrast Media; D003937:Diagnosis, Differential; D006801:Humans; D017543:Iliac Aneurysm / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D015641:Radiography, Interventional
D003287:Contrast Media