Management of Type II Endoleak From Internal Iliac Artery Immediately After Endovascular Aneurysm Repair

Inadvertent coverage of origin of internal iliac artery (IIA) during endovascular aneurysm repair may lead to type II endoleak. Except for open surgery, the endovascular solution is limited. We report a case with such complication that was successfully treated with coil embolization using retrograde extrastent approach. This is a new technique that has not been reported before, and as such, had been useful in the treatment of type II endoleak from IIA as an alternative to open ligation of IIA origin.

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Laparoscopic Ligation of Inferior Mesenteric Artery and Internal Iliac Artery for the Treatment of Symptomatic Type II Endoleak After Endovascular Aneurysm Repair

International Surgery ◽

10.9738/intsurg-d-13-00152.1 ◽

2014 ◽

Vol 99 (5) ◽

pp. 681-683 ◽

Cited By ~ 7

Author(s):

Junjie Zou ◽

Yueming Sun ◽

Hongyu Yang ◽

Hao Ma ◽

Jun Jiang ◽

...

Keyword(s):

Back Pain ◽

Iliac Artery ◽

Mesenteric Artery ◽

Inferior Mesenteric Artery ◽

Internal Iliac Artery ◽

Endovascular Aneurysm Repair ◽

Type Ii ◽

Type Ii Endoleak ◽

Internal Iliac ◽

Aneurysm Repair

Abstract We present a case undergoing successful laparoscopic ligation of the inferior mesenteric artery (IMA) and internal iliac artery (IIA) for the treatment of a symptomatic type II endoleak (T2E) after endovascular aneurysm repair (EVAR). The patient presented with abdominal and back pain 1 year after EVAR. Subsequent enhanced computed tomography scan showed aneurysm sac enlargement from 60 mm to 70 mm, and digital substraction angiography revealed a T2E caused by patent IMA and right IIA. Then the patient underwent successful laparoscopic ligation of the IMA and right IIA. Postprocedural angiogram demonstrated complete resolution of the type II endoleak, and no intraoperative complications occurred. Also, there was no remaining abdominal pain or back pain after the operation.

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Internal iliac coverage during endovascular repair of abdominal aortic aneurysms is a safe option: A preliminary study

Vascular ◽

10.1177/1708538116640077 ◽

2016 ◽

Vol 25 (1) ◽

pp. 28-35 ◽

Cited By ~ 2

Author(s):

Vinay Kansal ◽

Prasad Jetty ◽

Dalibor Kubelik ◽

George Hajjar ◽

Andrew Hill ◽

...

Keyword(s):

Computed Tomography ◽

Iliac Artery ◽

Internal Iliac Artery ◽

Endovascular Aneurysm Repair ◽

External Iliac Artery ◽

Aortic Aneurysms ◽

Type Ii ◽

Type Ii Endoleak ◽

Internal Iliac

Endovascular aneurysm repairs lacking suitable common iliac artery landing zones occasionally require graft limb extension into the external iliac artery, covering the internal iliac artery origin. The purpose of this study was to assess incidence of type II endoleak following simple coverage of internal iliac artery without embolization during endovascular aneurysm repair. Three hundred eighty-nine endovascular aneurysm repairs performed by a single surgeon (2004–2015) were reviewed. Twenty-seven patients underwent simple internal iliac artery coverage. Type II endoleak was assessed from operative reports and follow-up computed tomography imaging. No patient suffered type II endoleak from a covered internal iliac artery in post-operative computed tomography scans. Follow-up ranged from 0.5 to 9 years. No severe pelvic ischemic complications were observed. In conclusion, for selected cases internal iliac artery coverage without embolization is a safe alternative to embolization in endovascular aneurysm repairs, where the graft must be extended into the external iliac artery.

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Midterm Results After Abandoning Routine Preemptive Coil Embolization of the Internal Iliac Artery During Endovascular Aneurysm Repair

Journal of Endovascular Therapy ◽

10.1177/1526602819833068 ◽

2019 ◽

Vol 26 (2) ◽

pp. 238-244 ◽

Cited By ~ 1

Author(s):

Yannick W. ‘t Mannetje ◽

Pieter P. H. L. Broos ◽

Joep A. W. Teijink ◽

Rutger A. Stokmans ◽

Philippe W. M. Cuypers ◽

...

Keyword(s):

Iliac Artery ◽

Endovascular Repair ◽

Coil Embolization ◽

Internal Iliac Artery ◽

Endovascular Aneurysm Repair ◽

Type Ii ◽

Buttock Claudication ◽

Internal Iliac ◽

Aneurysm Growth

Purpose: To analyze the results of endovascular repair of common iliac artery (CIA) aneurysms without preemptive coil embolization of the internal iliac artery (IIA). Materials and Methods: Between January 2010 and July 2016, 79 patients (mean age 74.3±8.4 years; 76 men) underwent endovascular repair extending into the external iliac artery owing to a CIA aneurysm. The procedure was performed for a ruptured aneurysm in 22 (28%) patients. Eighty-one IIAs were intentionally covered. The median CIA diameter was 37 mm (range 20–90). The primary outcomes were the occurrence of type II endoleaks and the incidence of buttock claudication. Results: Five (6%) patients died within 30 days (4 with ruptured aneurysms and 1 elective case). Two type II endoleaks originating from a covered IIA were recorded; one required an endovascular intervention because of aneurysm growth. The other patient died of a rupture based on an additional type III endoleak. Mean follow-up was 37.6±26.3 months. Nineteen (26%) patients required a secondary intervention. Buttock claudication was reported in 21 (28%) of 74 patients and persisted after 1 year in 7. No severe ischemic complications as a result of IIA coverage were recorded, and no revascularization was required during follow-up. Conclusion: Treatment of CIA aneurysms by overstenting the IIA without preemptive coil embolization is safe and has a low risk of type II endoleak and aneurysm growth. Persisting buttock claudication is rare.

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