title: Treatment of a common iliac aneurysm by endovascular exclusion using the amplatzer vascular plug and femorofemoral crossover graft.
abstract: We report our initial experience using the Amplatzer Vascular Plug II (AVP2) in the treatment of a left common iliac aneurysm. Following investigation by computerized tomographic angiography and catheter angiography, a 79-year-old man was found to have a markedly tortuous iliac system, with a left common iliac artery aneurysm that measured 48 mm in maximal diameter. Due to the patient's age and comorbidities the surgical opinion was that conventional open repair was not suitable. However, due to the tortuous nature of the aneurysm and iliac vessels, standard endovascular repair, using either a bifurcated or an aorto-uni-iliac stent graft, was also not possible. A combined approach was used by embolizing the ipsilateral internal iliac artery using coils and excluding the aneurysm using two AVP2 occlusion devices, followed by femorofemoral crossover grafting. Total aneurysm occlusion was achieved using this method and this allowed the patient to have a much less invasive surgical procedure than with conventional open repair of common iliac aneurysms, thus avoiding potential comorbidity and mortality.
authors.affiliation: Department of Radiology, University Hospital of North Staffordshire, City General Hospital, Russell Building, Newcastle Road, Stoke-on-Trent, 8 Meaford Avenue, Stone, Staffordshire, ST15 8LT, UK. optimus2050@hotmail.com
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Coupe
authors.forename: Lynn
authors.initials: L
authors.lastname: Ling
authors.forename: Mark G
authors.initials: MG
authors.lastname: Cowling
authors.forename: John R
authors.initials: JR
authors.lastname: Asquith
authors.forename: Gregory B
authors.initials: GB
authors.lastname: Hopkinson
mesh_terms: D000368:Aged; D000792:Angiography; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D004621:Embolization, Therapeutic / Q000295:instrumentation*; D005263:Femoral Artery / Q000601:surgery*; D006801:Humans; D017543:Iliac Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D014057:Tomography, X-Ray Computed; D014654:Vascular Patency