Endovascular Treatment of Simultaneous Iliac and Superficial Femoral Arterial Pseudoaneurysms After Stenting Procedure Complications

Purpose: To report on the endovascular management of a patient affected by concomitant left common iliac artery and right superficial femoral artery (SFA) pseudoaneurysms after stent positioning. Case Report: A 77-year-old man affected by severe lower limb atherosclerosis was previously treated with iliac and femoropopliteal Supera stenting procedures; he presented to our emergency department because of bilateral severe claudication recurrence, back pain, and right groin region swelling. Angio-computed tomography (CT) depicted 2 pseudoaneurysms of the left common iliac artery and right SFA, due to stent fracture and stent intussusception, respectively. A 2-step endovascular treatment was planned using bilaterally covered stent-grafts to exclude vascular lesions from blood flow. The devices were successfully deployed without any complication. At 1 month, angio-CT confirmed patency of the implanted stent-grafts showing complete pseudoaneurysm exclusion without leaks. Conclusion: Endovascular approach can be a valid option in the treatment of pseudoaneurysms due to stenting procedure complications.

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AA3. Endovascular Treatment of Isolated Common Iliac Artery Aneurysms Using Iliac Branch Stent Grafts Without Aortic Component: A National Multicenter Registry

Journal of Vascular Surgery ◽

10.1016/j.jvs.2018.08.068 ◽

2018 ◽

Vol 68 (5) ◽

pp. e135

Author(s):

Alessia Giaquinta ◽

Nicola Mangialardi ◽

Piergiorgio Cao ◽

Fabio Verzini ◽

Carlo Pratesi ◽

...

Keyword(s):

Endovascular Treatment ◽

Iliac Artery ◽

Common Iliac Artery ◽

Stent Grafts ◽

Multicenter Registry

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Endovascular Treatment of Isolated Common Iliac Artery Aneurysms Using Iliac Branch Stent-grafts Without Aortic Component: A National Multicenter Registry

European Journal of Vascular and Endovascular Surgery ◽

10.1016/j.ejvs.2019.06.982 ◽

2019 ◽

Vol 58 (6) ◽

pp. e355-e356

Author(s):

Alessia Giaquinta ◽

Alberto Davì ◽

Ciro Ferrer ◽

Matteo Orrico ◽

Matteo Barbante ◽

...

Keyword(s):

Endovascular Treatment ◽

Iliac Artery ◽

Common Iliac Artery ◽

Stent Grafts ◽

Multicenter Registry

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Stent Fracture and Reocclusion After Placement of a Single Self-Expanding Stent in the Common Iliac Artery and Endovascular Treatment

CardioVascular and Interventional Radiology ◽

10.1007/s00270-008-9301-0 ◽

2008 ◽

Vol 31 (5) ◽

pp. 1013-1017 ◽

Cited By ~ 9

Author(s):

Wataru Higashiura ◽

Shoji Sakaguchi ◽

Kengo Morimoto ◽

Kimihiko Kichikawa

Keyword(s):

Endovascular Treatment ◽

Iliac Artery ◽

Common Iliac Artery ◽

Stent Fracture ◽

The Common

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Endovascular Treatment of Bilateral Common Iliac Artery Aneurysms Using Bifurcated–Unibody Stent Grafts

Annals of Vascular Surgery ◽

10.1016/j.avsg.2014.02.022 ◽

2014 ◽

Vol 28 (7) ◽

pp. 1790.e5-1790.e8 ◽

Cited By ~ 1

Author(s):

Xiaojun Shu ◽

Zhengfei Li ◽

Weiping Wang ◽

Xiaoqiang Li ◽

Wenhui Wang

Keyword(s):

Endovascular Treatment ◽

Iliac Artery ◽

Common Iliac Artery ◽

Stent Grafts

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Bursting Fracture of Balloon-Expandable Stent and Pseudoaneurysm Formation in the Left Common Iliac Artery and Endovascular Treatment With Graft Stent

Vascular and Endovascular Surgery ◽

10.1177/1538574418773465 ◽

2018 ◽

Vol 52 (7) ◽

pp. 556-560 ◽

Cited By ~ 1

Author(s):

Min Kim ◽

Dae In Lee ◽

Ju-Hee Lee ◽

Sang Yeub Lee ◽

Jang-Whan Bae ◽

...

Keyword(s):

Aortic Aneurysm ◽

Endovascular Treatment ◽

Iliac Artery ◽

Common Iliac Artery ◽

Left Common Iliac Artery ◽

Pseudoaneurysm Formation ◽

Bursting Fracture ◽

Aneurysm Repair ◽

Aortic Aneurysm Repair ◽

Extension Graft

Purpose: To report successful endovascular treatment of a previously implanted balloon-expandable stent bursting fracture with concomitant large pseudoaneurysm formation in the left common iliac artery (LCIA). Case Report: A 72-year-old man had been previously treated with balloon-expandable stents for severe stenotic lesion in the LCIA and left external iliac artery. Seven years later, the patient complained pain in both lower legs and back. Angiography demonstrated a 3.5-cm-sized pseudoaneurysm in the LCIA with embedded metal fragments around the lesion. An endovascular treatment was selected using a limb extension graft for endovascular aortic aneurysm repair. The device was successfully deployed, and no endoleak was observed. At 1-month follow-up, computed tomography scan confirmed patency of the implanted stent graft devices in the LCIA and the absence of any endoleak. Conclusion: Endovascular approach using a limb extension graft stent for endovascular aortic aneurysm repair can be used for treating stent fracture-related pseudoaneurysm in the common iliac artery.

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Clinical case of successful endovascular correction of an arterio-ureteral fistula

Patologiya krovoobrashcheniya i kardiokhirurgiya ◽

10.21688/1681-3472-2021-3-100-105 ◽

2021 ◽

Vol 25 (3) ◽

pp. 100

Author(s):

M. A. Chernyavsky ◽

M. S. Mosoyan ◽

A. G. Vanyurkin ◽

N. V. Susanin ◽

A. N. Kazantsev

Keyword(s):

Endovascular Treatment ◽

Iliac Artery ◽

Clinical Case ◽

Common Iliac Artery ◽

Pathological Condition ◽

Haemorrhagic Shock ◽

Surgical Trauma ◽

External Compression ◽

Left Common Iliac Artery ◽

Advantages And Disadvantages

Arterio-ureteral fistulas are a pathological condition characterised by the appearance of a defect between the blood vessels and adjacent distal segments of the ureter. Arterio-ureteral fistulas are relatively rare and potentially life-threatening, since they are associated with a high risk of developing haemorrhagic shock against the background of recurrent massive haematuria. This study describes the successful endovascular treatment of arterio-ureteral fistulas in a 51-year-old female patient. Evisceration of the pelvic organs was performed, followed by uretero-cutaneostomy and colostomy. Ureteral stents were installed to improve the outflow of urine and prevent ureteral stenosis. After stent removal, episodes of recurrent profuse bleeding from uretero-cutaneostomy occurred. On admission, multi-spiral computed tomography with angiography of the iliac arteries was performed. Extravasation of the contrast agent was not detected; however, external compression of the left common iliac artery by the left ureter was identified. After further examination, a balloon-expandable stent-graft was implanted into the left common iliac artery. The postoperative period thereafter was uneventful. This clinical case demonstrates the highly efficient endovascular treatment of the presented pathology and exemplifies the need for an integrated and multidisciplinary approach in the diagnosis and treatment of arterio-ureteral fistulas. Minimally invasive techniques can reduce surgical trauma and quickly isolate pathological blood discharge from the artery into the ureter. The advantages and disadvantages of endovascular technologies in the treatment of the presented pathology are also discussed.Received 16 February 2021. Revised 11 March 2021. Accepted 12 March 2021.Funding: The study did not have sponsorship.Conflict of interest: The authors declare no conflicts of interests.Contribution of the authors Drafting the article: A.G. Vanyurkin, A.N. Kazantsev Critical revision of the article: M.A. Chernyavsky, N.V. Susanin, M.S. Mosoyan Surgical treatment: M.A. Chernyavsky, A.G. Vanyurkin, N.V. Susanin Final approval of the version to be published: M.A. Chernyavsky, M.S. Mosoyan, A.G. Vanyurkin, N.V. Susanin, A.N. Kazantsev

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Endovascular Treatment of Isolated Common Iliac Artery Aneurysms With Short Necks Using Bifurcated Stent-Grafts

Korean Circulation Journal ◽

10.4070/kcj.2010.40.7.343 ◽

2010 ◽

Vol 40 (7) ◽

pp. 343 ◽

Cited By ~ 3

Author(s):

Jin Wi ◽

Young-Guk Ko ◽

Jung-Sun Kim ◽

Donghoon Choi ◽

Myeong-Ki Hong ◽

...

Keyword(s):

Endovascular Treatment ◽

Iliac Artery ◽

Common Iliac Artery ◽

Stent Grafts

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Transbrachial and transfemoral approaches combined with visceral protection for the treatment of juxtarenal aortoiliac occlusive disease: Technical issues and clinical outcomes

Vascular ◽

10.1177/17085381211023229 ◽

2021 ◽

pp. 170853812110232

Author(s):

Peixian Gao ◽

Changliang Li ◽

Xuejun Wu ◽

Gang Li ◽

Dianning Dong ◽

...

Keyword(s):

Endovascular Treatment ◽

Bare Metal Stents ◽

Covered Stent ◽

Occlusive Disease ◽

Metal Stents ◽

Infrarenal Aorta ◽

Bare Metal ◽

Stent Grafts ◽

Aortoiliac Occlusive Disease

Purpose To evaluate the safety and efficacy of transbrachial and transfemoral approaches combined with visceral protection for the endovascular treatment of juxtarenal aortoiliac occlusive disease (AIOD) over an average 19-month follow-up period. Methods In this retrospective analysis, all patients with juxtarenal AIOD at a single institution were reviewed from June 2015 to January 2020. Patient characteristics, angiographic results, and follow-up outcomes were retrospectively recorded. The indications for treatment were critical limb threatening ischemia in 12 patients and bilateral claudication in five patients. Percutaneous access via the left brachial artery was first obtained to recanalize the infrarenal occluded lesions. After that, femoral accesses were achieved. A 4-Fr catheter, a 4 mm balloon, or a 6-Fr 90-cm-long sheath was used to complete visceral artery protection. Results A total of 17 juxtarenal AIOD patients (14 males; mean age, 63.4 ± 8.1 years) underwent endovascular treatment. The technical success rate was 100%. Complete reconstruction was achieved in 15 (88.2%) patients. The infrarenal aorta was reconstructed with kissing covered stent grafts ( n = 7), kissing bare-metal stents ( n = 2), covered stent grafts ( n = 2), bare-metal stents ( n = 1), or the off-label use of iliac limb stent grafts ( n = 5). Renal embolization was found in 3 (17.6%) patients during intraoperative angiography. There was 1 (5.9%) case of distal runoff embolization after CDT and 1 (5.9%) case of left iliac artery rupture. One (5.9%) death occurred due to acute myocardial infarction 20 days after the operation. The average follow-up period was 19.3 ± 16.7 months (range, 1–54 months) in the remaining 16 cases. The renal artery patency rate was 100%. The estimated cumulative primary patency rates were 92.3% at 12 months and 59.3% at 36 months according to the Kaplan–Meier method. Conclusions Transbrachial and transfemoral approaches combined with visceral protection offer a safe and effective alternative to open revascularization for the endovascular treatment of juxtarenal AIOD.

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Isolated iliac artery aneurysm in association with congenital pelvic kidney treated with iliac branch device: case report

Journal of Cardiothoracic Surgery ◽

10.1186/s13019-021-01409-x ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Guilherme Centofanti ◽

Kenji Nishinari ◽

Bruna De Fina ◽

Rafael Noronha Cavalcante ◽

Mariana Krutman ◽

...

Keyword(s):

Computed Tomography ◽

Iliac Artery ◽

Computed Tomography Angiography ◽

Common Iliac Artery ◽

Artery Aneurysm ◽

Maximum Diameter ◽

Pelvic Kidney ◽

Iliac Artery Aneurysm ◽

Left Common Iliac Artery ◽

Common Iliac Artery Aneurysm

Abstract Background Association of abdominal aortic aneurysm with congenital pelvic kidney is rare and association with isolated iliac artery aneurysm is not yet described in the literature. Case presentation We present a case of successful repair of an isolated common iliac artery aneurysm associated with a congenital pelvic kidney treated by an endovascular technique. A 75-year-old man was referred for the treatment of an asymptomatic left common iliac artery aneurysm. A computed tomography angiography revealed an isolated left common iliac artery aneurysm and a left pelvic kidney. The maximum diameter of the aneurysm was 32 mm. The congenital pelvic kidney was supplied by three small superior polar arteries that emerged from the proximal non-aneurysmal portion of the common iliac artery and the main artery that arose from the left internal iliac artery. The aneurysm exclusion was accomplished by using an iliac branch device (Gore Excluder Iliac Branch, Flagstaff, AZ). The 1 and 6 months computed tomography angiography after the procedure demonstrated complete exclusion of the aneurysm and preservation of all renal arteries. Conclusion Treating patients with an association of iliac artery aneurysms and pelvic kidneys can be a challenge due the variable arterial anatomy. The use of iliac branch device is a safe and effective alternative in selected cases.

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