title: Endovascular treatment of abdominal aortic aneurysms combined with bilateral common and internal iliac aneurysms.
abstract: BACKGROUND
  Combined aneurysms of aortic and iliac arteries are rare with a prevalence of less than 0.1%. However, these combined aneurysms are associated with a high incidence of thrombosis, distal embolism, or rupture. Endovascular repair is a therapeutic option and includes embolization of the internal iliac artery in numerous cases. Embolization of the internal iliac artery may cause severe ischemia with hip and buttock complications in 2-5%. Therefore, preservation of internal iliac arteries is essential to reduce complications.
  
  
  METHODS
  We describe in detail an endovascular procedure for combined abdominal aortic (diameter of 8.6 cm) and bilateral common and internal iliac aneurysm (diameter of the left side: 6.4 cm; diameter of the right side: 4.3 cm) in a 44-year-old patient caused by media necrosis Erdheim-Gsell. The blood flow of both internal arteries was preserved in this patient.
  
  
  RESULTS
  Operation was done without any complications. Conversion to an open procedure was not necessary. During follow up (3, 6, and 12 months after operation) the patient did not develop any signs of severe hip and buttock complications. Furthermore, sonography and CT angiography revealed a good blood flow via the internal and external iliac arteries.
  
  
  CONCLUSIONS
  Endovascular repair of abdominal aortic aneurysms combined with bilateral common and internal iliac aneurysms offers a promising minimal invasive procedure. Most importantly, this technique is less invasive than open operations and reduces complications by preserving the pelvic perfusion.
authors.affiliation: Department of Surgery, University of Munich (LMU), Nussbaumstr. 20, D-80336 Munich, Germany.
authors.forename: Mojtaba
authors.initials: M
authors.lastname: Sadeghi-Azandaryani
authors.forename: Hanna
authors.initials: H
authors.lastname: Strube
authors.forename: Daniel
authors.initials: D
authors.lastname: Chappell
authors.forename: Marcus
authors.initials: M
authors.lastname: Treitl
authors.forename: Ludwig C
authors.initials: LC
authors.lastname: Hinske
authors.forename: Bernd
authors.initials: B
authors.lastname: Steckmeier
authors.forename: Jens
authors.initials: J
authors.lastname: Heyn
mesh_terms: D000328:Adult; D015901:Angiography, Digital Subtraction; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D001027:Aortography / Q000379:methods; D019917:Blood Vessel Prosthesis Implantation; D003560:Cysts / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D057510:Endovascular Procedures; D006801:Humans; D017543:Iliac Aneurysm / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D010388:Pelvis / Q000098:blood supply; D012039:Regional Blood Flow; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome