Endovascular treatment of a ruptured iliac aneurysm previously excluded.
We report a case of an isolated ruptured iliac artery aneurysm that had previously been treated, 25 months before, with iliac endovascular exclusion. Urgent computed tomographic (CT) scan showed the retroperitoneal hematoma and a type IA endoleak. On an emergency basis, at the operating room, an aortouni-iliac graft and femorofemoral crossover bypass were performed, successfully. This is a very rare but serious complication and requires careful indication and close follow-up with CT. In isolated common iliac artery aneurysms, the common iliac artery and distal aorta may tend to enlarge with failure of the endograft proximal attachment site and migration, thus leading to a late aneurysm rupture. A safe length and width, especially of the proximal sealing zone, should be accurately defined and closely followed up, or otherwise complete exclusion of the aortoiliac arteries should be considered.
Plaza-Martínez
Angel
A
Department of Angiology, Vascular and Endovascular Surgery, Hospital Universitario Dr. Peset, Valencia, Spain. plaza_ang@gva.es
Gómez-Palonés
Francisco
F
Zaragozá-García
José Miguel
JM
Martínez-Parreño
Carlos
C
AlRaies-Bolaños
Bader
B
Ortiz-Monzón
Eduardo
E
D000368:Aged; D017542:Aneurysm, Ruptured / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation; D005548:Foreign-Body Migration / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D006406:Hematoma / Q000209:etiology / Q000601:surgery; D006801:Humans; D017543:Iliac Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation; D014057:Tomography, X-Ray Computed