Isolated internal iliac artery infected pseudoaneurysm occlusion using endovascular coil embolisation

2021 ◽  
Vol 14 (6) ◽  
pp. e239005
Author(s):  
Gorrepati Rohith ◽  
Bachavarahalli Sriramareddy Rajesh ◽  
KM Abdulbasith ◽  
Sathasivam Sureshkumar

A 34-year-old man presented with painful swelling in the right gluteal region. The MRI showed right sacroiliitis and adjacent intramuscular abscess. The abscess was drained by a pigtail insertion followed by incision and drainage. The patient developed persistent bleeding from the drainage site. CT angiogram revealed a large pear-shaped pseudoaneurysm arising from the anterior branch of the right internal iliac artery. The patient had Abrus precatorius poisoning previously resulting in methicillin-resistant Staphylococcus aureus septicaemia, which incited above events. Digital subtraction angiography with coil embolisation of the right internal iliac artery was done under the cover of culture-specific antibiotics along with thorough wound debridement following which the patient’s condition improved. Isolated infected pseudoaneurysms of internal iliac arteries, although rare, should be considered in cases of complicated sacroiliitis. Under antibiotic cover, endovascular coil embolisation can be considered as a treatment strategy to treat complicated infected pseudoaneurysms located in difficult anatomical locations.

VASA ◽  
2007 ◽  
Vol 36 (2) ◽  
pp. 138-142 ◽  
Author(s):  
Sixt ◽  
Rastan ◽  
Schwarzwälder ◽  
Schwarz ◽  
Frank ◽  
...  

We report a case of an 86-year-old asymptomatic patient, who underwent a repair of the infrarenal abdominal aortic aneurysm 13 years ago. He presented with a left internal iliac artery (IIA) aneurysm with a short neck of 3 mm, and a partially thrombosed lumen with a cross sectional diameter of 5.6 cm and a length of 8.9 cm. With respect to the high morbidity and mortality and awareness of the recommendation to treat aneurysms larger than 3 cm in diameter, we discussed the optimal treatment options. As endoprosthesis implantation was not feasible we performed a selective coil embolisation of the distal branches of the left internal artery, which successively lead to a complete thrombosis of the aneurysm. Although coiling additive to other procedures is applied frequently, only few cases of internal iliac aneurysm were treated with coil embolisation alone. During a first outpatient visit 2 months following the procedure the aneurysm was still completely thrombosed.


2013 ◽  
Vol 45 (3) ◽  
pp. 220-226 ◽  
Author(s):  
R.A. Stokmans ◽  
E.M. Willigendael ◽  
J.A.W. Teijink ◽  
J.A. Ten Bosch ◽  
M.R.H.M. van Sambeek ◽  
...  

2014 ◽  
Vol 20 (4) ◽  
pp. 219-227
Author(s):  
Oana Popa ◽  
P. Bordei ◽  
D. Iliescu ◽  
C. Ionescu

Abstract The origin of the internal iliac artery, right and left, was studied in 76 cases, 58 cases of male (76.32% of all cases) and 18 female cases (23.68% of all cases). The origin of the internal iliac arteries was considered in relation to the spine (lumbar-sacral). The right internal iliac artery males originates in a range from the upper edge of L4 vertebra - the lower part of fin sacral. It is found that in males, in most cases, 43 cases (74.14% of male cases), right internal iliac artery originates at different levels of sacral fin. We considered that the right iliac artery low origin only the cases in the lower part of the fin sacral, 10 cases (17.24% of male cases). Cases of high origin of the artery, above the fin sacral we found it in 15 cases (25.86% of male cases). From high origins, in the upper edge of the L4 vertebra and intervertebral disc at L4-L5, I met only one single case. Right internal iliac artery in females originated in a range between the upper edges of L5 - the lower part of sacral fin. In females, the right internal iliac artery origin, is located within narrower than in men, but in women, most frequently, 14 cases (77.78% of female the cases) was the origin of the internal iliac located at different levels of sacral fin. The females have not met internal iliac origin above the L5 vertebra or intervertebral disc level L4-L5. High origin was met it in 4 cases (22.22% of female the cases) and low origin in 6 cases (33.33% of female the cases). The level of the left internal iliac artery origin we studied 78 cases, finding it in the same range as in males, i.e., the upper edge of L4 vertebra - the front of the sacrum. In males, on a number of 57 cases (73.08% of all cases) the origin of the left internal iliac artery was made between the upper edge of the vertebra L4 - the front face of the sacrum, most commonly, in 44 cases (77 19% of male the cases) located in the sacral fin. The artery high origin I found it in 9 cases (15.79% of male the cases) and low origin in 18 cases (31.58% of male the cases). I have not met artery origin at L5-S1 intervertebral disc. In terms of low origin, only in males, the left internal iliac artery originated from the anterior to the sacrum, something not found the right internal iliac artery. In females, the 18 cases followed, had their origins in the range lower half of the L5 - middle sacral fin, 17 cases (94.44% of female the cases), terminating at the sacral fin. It is found that in women the origin of the left internal iliac artery is within narrower than the other cases described so far, showing the highest level of origin, this artery in females do not possess low origin. The high origin is present in a small percentage, only 5.56% of cases, encountering any case the origin of the left internal iliac artery is located at the L4 vertebra or the intervertebral discs at L4-L5 or L5-S1. Internal iliac artery diameter was followed on 90 cases, 44 cases for the right internal iliac artery and 46 cases for left internal iliac artery. In males, the right internal iliac artery I found a caliber between 3 to 9.8 mm. In women the right internal iliac artery caliber found between 3.9 to 6.9 mm.


2018 ◽  
Author(s):  
NS Patel ◽  
Y Gao ◽  
S Aravind ◽  
M Fuglestad ◽  
GP Casale ◽  
...  

ABSTRACTIntroductionThe development of collateral vasculature is a key mechanism compensating for arterial occlusions in patients with peripheral artery disease (PAD). We aimed to examine the development of collateral pathways after ligation of native vessels in a porcine model of PAD.MethodsRight hindlimb Ischemia was induced in domestic swine (N=11, male, kg) using two different versions of arterial ligation. Version 1 (N=6) consisted of ligation/division of the right external iliac, profunda femoral (RPFA) and superficial femoral arteries (RSFA). Version 2 (N=5) consisted of the ligation of Version 1 with additional ligation/division of the right internal iliac artery (RIIA). Development of collateral pathways was evaluated with standard angiography at baseline (prior to arterial ligation) and at termination (4-8 weeks later). Relative luminal diameter of the arteries supplying the ischemic right hindlimb were determined by 2D angiography, as percent of the size of the distal aortic diameter.ResultsThe dominant collateral pathway that developed after version 1 ligation connected the RIIA to the RPFA and RSFA/popliteal artery. Mean luminal diameter (± standard error) of the RIIA at termination increased by 38% (P<0.05) compared to baseline. Two co-dominant collateral pathways developed in version: (i) from the common internal iliac trunk and left internal iliac artery to the reconstituted RIIA, which then supplied the RPFA and RSFA/popliteal arteries; and (ii) from left profunda artery to the reconstituted RPFA. Mean diameter of the common internal iliac trunk and left profunda artery both increased at termination in the range of 20% (p < 0.05).ConclusionTwo versions of hindlimb ischemia induction (right ilio-femoral artery ligation with and without right internal iliac artery ligation in swine produced differing collateral pathways, along with changes to the diameter of the inflow vessels (i.e., arteriogenesis). Radiographic and anatomical data of the collateral formation in this porcine model should have value in investigation of the pathophysiology of hindlimb ischemia, and assessment of angiogenic therapies as potential treatments for PAD.


2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Phitsanu Mahawong ◽  
Tanop Srisuwan ◽  
Kittipan Rerkasem

A 70-year-old man presented with severe pain on the right side of the abdomen for 7 days. An abdominal CT angiographic scan showed an impending rupture of a large right internal iliac artery aneurysm which compressed to a right ureter causing hydroureteronephrosis. Fornix rupture of a right duplex kidney was also detected. Selective embolization of right gluteal arteries and then ligation of the right internal iliac artery and right ureterotomy with double J stenting were performed. At the 4-month follow-up appointment, an abdominal ultrasound demonstrated a decrease in the size of the aneurysm and no hydroureteronephrosis after the removal of double J stent.


2020 ◽  
Vol I (2) ◽  
pp. 26-28
Author(s):  
Gözde Girgin

We describe a case of internal iliac artery pseudoaneurysm in a 38-year-old woman with postpartum hemorrhage following uterine artery ligation and uterine rupture repair. A 38-year-old female without any comorbid conditions or diseases who had previously given birth with a normal vaginal delivery was admitted to an external healthcare center with pain. The patient presented to our hospital on the 7th postoperative day with abdominal and side pain. We diagnosed the patient with ultrasonography and CT-angiogram imaging and she was treated with selective embolization. On the second day following the procedure, a regression in the previously identified hydronephrosis was observed using renal ultrasonography. The patient was discharged on the 14th day of hospitalization when she was clinically stable. Patients presenting with abdominal pain and hemorrhage after cesarean sections should be carefully evaluated for the possibility of uncommon complications, especially pseudoaneurysms, preferably with a multidisciplinary approach.


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