title: Perigraft Plug Embolization of the Internal Iliac Artery and Implantation of a Bifurcated Stentgraft: One Treatment Option for Insufficient Tubular Stentgraft Repair of a Common Iliac Artery Aneurysm.
abstract: We report an endovascular technique for the treatment of type Ia endoleak after a plain tubular stentgraft had been implanted for a large common iliac artery aneurysm with an insufficient proximal landing zone and without occlusion of the hypogastric in another hospital. CT follow-up showed an endoleak with continuous sac expansion over 12 months. This was classified as type Ia by means of dynamic contrast-enhanced MRI. Before a bifurcated stentgraft was implanted to relocate the landing zone more proximally, the still perfused ipsilateral hypogastric artery was embolized to prevent a type II endoleak. A guidewire was manipulated alongside the indwelling stentgraft. The internal iliac artery could then be selectively intubated followed by successful plug embolization of the vessel's orifice despite the stentgraft being in place.
authors.affiliation: Department for Radiology and Nuclear Medicine, University Hospital of Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany. janpeter.goltz@uksh.de.
authors.forename: Jan Peter
authors.initials: JP
authors.lastname: Goltz
authors.affiliation: Department for Radiology and Nuclear Medicine, University Hospital of Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany.
authors.forename: Julia
authors.initials: J
authors.lastname: Loesaus
authors.affiliation: Department for Radiology and Nuclear Medicine, University Hospital of Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany.
authors.forename: Alex
authors.initials: A
authors.lastname: Frydrychowicz
authors.affiliation: Department for Radiology and Nuclear Medicine, University Hospital of Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany.
authors.forename: Jörg
authors.initials: J
authors.lastname: Barkhausen
authors.affiliation: Clinic for Surgery, University Hospital of Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany.
authors.forename: Marcus
authors.initials: M
authors.lastname: Wiedner
mesh_terms: D000368:Aged; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D003131:Combined Modality Therapy; D003287:Contrast Media; D004621:Embolization, Therapeutic / Q000379:methods*; D057867:Endoleak / Q000000981:diagnostic imaging / Q000628:therapy; D057510:Endovascular Procedures / Q000379:methods*; D006801:Humans; D017543:Iliac Aneurysm / Q000175:diagnosis / Q000628:therapy*; D007083:Iliac Artery; D008279:Magnetic Resonance Imaging; D008297:Male; D015607:Stents; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media
keywords: Common iliac artery aneurysm; EVAR; Embolization; Endovascular repair