Distal embolization and proximal stent-graft deployment: a dual approach to endovascular treatment of ruptured superior gluteal artery aneurysm.
Aneurysmal disease of the hypogastric branches is rare; it may be life-threatening, and the treatment is often challenging. Herein, we report the case of an 81-year-old man with arterial hypertension, obesity, renal insufficiency, and psychiatric disorders who was emergently admitted for a symptomatic ruptured aneurysm of a hypogastric arterial branch, as seen on magnetic resonance angiography. Endovascular treatment was performed by means of a dual approach: distal embolization with microspheres and Gianturco coils, followed by proximal complete exclusion via deployment of a stent-graft in the common iliac artery. The outcome was favorable, with complete exclusion of the aneurysm and normalization of renal function. Endovascular treatment with distal embolization and proximal stent-graft release can be safe and effective, and the technique can be used in emergency circumstances with good morphologic and clinical results.
Melissano
Germano
G
Department of Vascular Surgery, Scientific Institute H. San Raffaele, Vita-Salute University School of Medicine, 20132 Milan, Italy. g.melissano@hsr.it
Venturini
Massimo
M
Baccellieri
Domenico
D
Calliari
Fabio
F
Del Maschio
Alessandro
A
Chiesa
Roberto
R
D000369:Aged, 80 and over; D017542:Aneurysm, Ruptured / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D002081:Buttocks / Q000098:blood supply*; D002315:Cardiopulmonary Bypass; D004621:Embolization, Therapeutic; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D019736:Prostheses and Implants; D011859:Radiography; D015607:Stents