title: Distal embolization and proximal stent-graft deployment: a dual approach to endovascular treatment of ruptured superior gluteal artery aneurysm.
abstract: 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.
authors.affiliation: Department of Vascular Surgery, Scientific Institute H. San Raffaele, Vita-Salute University School of Medicine, 20132 Milan, Italy. g.melissano@hsr.it
authors.forename: Germano
authors.initials: G
authors.lastname: Melissano
authors.forename: Massimo
authors.initials: M
authors.lastname: Venturini
authors.forename: Domenico
authors.initials: D
authors.lastname: Baccellieri
authors.forename: Fabio
authors.initials: F
authors.lastname: Calliari
authors.forename: Alessandro
authors.initials: A
authors.lastname: Del Maschio
authors.forename: Roberto
authors.initials: R
authors.lastname: Chiesa
mesh_terms: 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