scholarly journals Asymptomatic bilateral common iliac artery dissections in previously undiagnosed vascular Ehlers-Danlos syndrome

2019 ◽  
Vol 12 (11) ◽  
pp. e231537
Author(s):  
Matthew Lavoie ◽  
Jason Reese
Keyword(s):  
Iliac Artery ◽  
Common Iliac Artery ◽  
Clinical History ◽  
Artery Dissection ◽  
Intravenous Contrast ◽  
Ehlers Danlos Syndrome ◽  
Left Common Iliac Artery ◽  
Ct Angiogram ◽  
The Right ◽  
Danlos Syndrome

We report a case of a 35-year-old woman found to have vascular Ehlers-Danlos syndrome (vEDS) after family history of sudden death due to aortic dissection in her otherwise healthy brother prompted further imaging workup and consideration of an underlying heritable genetic condition. CT angiogram of the aorta with intravenous contrast revealed an abdominal aortic artery dissection below the level of the renal arteries extending from the bifurcation into the left common iliac artery with an additional focal dissection of the right common iliac artery. To the author’s knowledge, this is the first report of asymptomatic bilateral common iliac artery dissections as a part of the initial presentation of a patient with underlying vEDS. Additionally, this case highlights the importance of familial diagnostic screening in inherited vasculopathies. Clinical history, genetic testing and management are discussed.

Spontaneous Ruptured Dissection of the Right Common Iliac Artery in a Patient with Classic Ehlers–Danlos Syndrome Phenotype

2015 ◽  
Vol 29 (3) ◽  
pp. 595.e11-595.e14 ◽  
Author(s):  
Rick Gaines ◽  
Brad T. Tinkle ◽  
Pegge M. Halandras ◽  
Omar Al-Nouri ◽  
Paul Crisostomo ◽  
...  
Keyword(s):  
Iliac Artery ◽  
Common Iliac Artery ◽  
Ehlers Danlos Syndrome ◽  
The Right ◽  
Danlos Syndrome

scholarly journals Differentiation of vascular claudication due to bilateral common iliac artery stenosis versus neurogenic claudication with spinal stenosis

2021 ◽  
Vol 12 ◽  
pp. 231
Author(s):  
Lisa B. E. Shields ◽  
Vasudeva G. Iyer ◽  
Stephen B. Self ◽  
Yi Ping Zhang ◽  
Christopher B. Shields
Keyword(s):  
Iliac Artery ◽  
Groin Pain ◽  
Common Iliac Artery ◽  
Neurogenic Claudication ◽  
Low Back ◽  
Left Common Iliac Artery ◽  
Ct Angiogram ◽  
Calcified Plaque ◽  
Iliac Artery Stenosis ◽  
The Right

Background: Differentiating between neurogenic and vascular claudication may be difficult. Vascular claudication due to aortic and iliac artery occlusions may present as low back, hip, and buttock pain while walking short distances. These findings are often very similar to those seen for neurogenic claudication attributed to lumbar stenosis. Case Description: A 68-year-old female presented with low back, right hip, and groin pain while walking short distances. She had previously undergone lumbar and cardiac surgery. Now, with negative repeated lumbar studies, the CT angiogram (CTA) revealed a dense calcified plaque in the right common iliac artery resulting in 90% stenosis at its origin and <50% stenosis of the left common iliac artery. Once bilateral common iliac artery kissing stents were placed, the patient’s symptoms resolved. Conclusion: Spine surgeons should be aware that vascular and neurogenic claudication may mimic each other. Obtaining MR studies of the lumbar spine and EMG/NCV, along with the appropriate vascular studies (CTAs), help differentiate between the two, and result in the appropriate operative choices.

scholarly journals Urgent Endovascular Treatment of Iliac Artery Pseudoaneurysm in Patient with Ehlers-Danlos Syndrome: A Case Report

2020 ◽  
Vol 8 (C) ◽  
pp. 156-160
Author(s):  
Aleksandar Gjoreski ◽  
Ivona Jovanoska ◽  
Gjorgi Dungevski ◽  
Nikola Lazovski ◽  
Menka Lazareska
Keyword(s):  
Endovascular Treatment ◽  
Iliac Artery ◽  
Significant Risk ◽  
Vascular Complications ◽  
High Morbidity ◽  
Ehlers Danlos Syndrome ◽  
Artery Pseudoaneurysm ◽  
Type Iv ◽  
The Right ◽  
Danlos Syndrome

BACKGROUND: Ehlers-Danlos syndrome (EDS) type IV is a heritable disorder of connective tissue that is mainly associated with vascular maladies such as aneurysms, pseudoaneurysms, and dissections with or without spontaneous rupture. Historically, vascular complications in EDS IV have been treated conservatively whenever possible, due to the high morbidity and mortality after vascular interventions, whether open or endovascular. We present a case of a ruptured pseudoaneurysm of the right common iliac artery in a 18-year-old male, who was successfully treated by endovascular approach and later diagnosed with EDS type IV. CASE PRESENTATION: A 18-year-old male patient was admitted in ER with sharp pain in the right hypogastrium, hypotensive and with reduced blood parameters. Multiphasic modern computed tomography (MDCT) scan of abdomen and pelvis revealed massive ride sided pelvic and retroperitoneal hematoma. The presence of pseudoaneurysms on both common iliac arteries (CIA) was detected, with small ulcer on the right side and a focal dissection on the left side. An urgent endovascular repair of the ruptured pseudoaneurysm on the right CIA with covered stent was performed. Patient’s laboratory parameters and clinical status improved significantly within the next few days. CONCLUSIONS: Vascular repair in EDS-IV patients carries significant risk and should be indicated very carefully. Endovascular treatment for these patients is feasible and should be considered as an alternative to open surgery in some challenging cases as this one.

Successful endovascular treatment of a ruptured gigantic pseudoaneurysm of the common iliac artery secondarily complicated by infection

Vascular ◽  
2013 ◽  
Vol 21 (3) ◽  
pp. 189-191 ◽  
Author(s):  
Efstratios I Georgakarakos ◽  
Evagelos S Nikolopoulos ◽  
Michael A Karanikas ◽  
Michalis Mantatzis ◽  
Miltos K Lazarides
Keyword(s):  
Endovascular Treatment ◽  
Iliac Artery ◽  
Common Iliac Artery ◽  
Hypovolemic Shock ◽  
Intravenous Contrast ◽  
Surgical Department ◽  
Maximal Diameter ◽  
Active Extravasation ◽  
The Common ◽  
The Right

We report our experience with a case of emergent endovascular treatment of a large ruptured pseudoaneurysm of the common iliac artery. A 65-year-old male was admitted to the surgical department in hypovolemic shock, due to active retroperitoneal bleeding. A computerized tomography scan with intravenous contrast revealed a ruptured gigantic pseudoaneurysm of the right common iliac artery, with a maximal diameter of 7 cm and retroperitoneal hematoma. An intraoperative angiogram revealed active extravasation through the neck of the pseudoaneurysm, which was successfully sealed with the placement of a stent graft (Medtronic Endurant®) limb component. Infection of the pseudoaneurysm sac after one month was successfully treated with catheter drainage. No short-term relapse occurred. Endovascular management should be part of the basic surgical armamentarium on emergent basis, since it provides a fast and safe solution, especially when a patient's co-morbitities preclude open management and hemodynamic and anatomical status allows endovascular treatment.

scholarly journals Balloon Occlusion of the Contralateral Iliac Artery to Assist Recanalization of the Ipsilateral Iliac Artery in Total Aortoiliac Occlusion: A Technical Note

2013 ◽  
Vol 2013 ◽  
pp. 1-5
Author(s):  
Abdel Aziz A. Jaffan
Keyword(s):  
Iliac Artery ◽  
Common Iliac Artery ◽  
Balloon Occlusion ◽  
Technical Note ◽  
Left Common Iliac Artery ◽  
Endovascular Recanalization ◽  
Common Causes ◽  
The Right ◽  
Aortoiliac Occlusion ◽  
Causes Of Failure

Endovascular recanalization of chronic total aortoiliac occlusion is technically challenging. Inability to reenter the true aortic lumen, following retrograde iliac recanalization, is one of the most common causes of failure. We describe a case of a total aortoiliac occlusion where balloon occlusion of the right common iliac artery, following its recanalization from a brachial approach, was used to facilitate antegrade recanalization of the occluded contralateral left common iliac artery.

A Preliminary Study of Gadobenate Dimeglumine Enhanced Magnetic Resonance Angiography Detection of Prostatic Artery Anatomy

2020 ◽  
Vol 10 (3) ◽  
pp. 560-565
Author(s):  
Yanguang Shen ◽  
Jinlong Zhang ◽  
Peng Song ◽  
Lu Ma ◽  
Yan Zhong ◽  
...  
Keyword(s):  
Image Quality ◽  
Iliac Artery ◽  
Common Iliac Artery ◽  
Signal To Noise Ratio ◽  
Gadobenate Dimeglumine ◽  
Time Resolved ◽  
Left Common Iliac Artery ◽  
Internal Iliac ◽  
The Right ◽  
Prostatic Artery

Background: To describe the feasibility of anatomy and imaging findings of the prostatic arteries (PAs) on contrast-enhanced MR angiography (ce-MRA). Methods: This prospective study enrolled 7 patients undergoing pelvic 3.0 T ce-MRA and selective pelvic digital subtraction angiography before prostatic artery embolization (PAE). Four patients underwent fluoroscopically triggered ce-MRA and 3 patients underwent time-resolved imaging of contrast kinetics. PAE was performed within one week of MRA. Two radiologists independently analyzed MRA findings. The analyzed parameters included the number of independent PAs and their origin, trajectory, and anastomoses with adjacent arteries. Image quality in terms of signal-to-noise ratio (SNR) and contrast-tonoise ratio (CNR) to visualize common iliac artery and its branches including prostatic arteries was compared between the two groups. Results: A total of 17 PAs were demonstrated in 7 cases. The diagnostic accuracy of MRA in detecting bilateral PAs was 58.82%. Moreover, 71.42% of the patients had only one PA in one side, and 7.14% had independent PAs. The mean diameter of 10 PAs was 1.39 ± 0.46 mm. About 29.41% of PAs originated from the obturator arteries and 29.41% from the pudendal arteries. Bilateral PAs were found to be symmetric in 3 cases and asymmetric in 4 cases. No significance difference was found between the image quality of the two groups, except for the signal intensity of the right common iliac artery and right internal iliac artery and SNR and CNR of the left common iliac artery. Conclusions: This study shows that ce-MRA is able to detect PA, and can provide guidance for PAE.

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