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Treatment of a Common Iliac Aneurysm by Endovascular Exclusion Using the Amplatzer Vascular Plug and Femorofemoral Crossover Graft

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Abstract

We report our initial experience using the Amplatzer Vascular Plug II (AVP2) in the treatment of a left common iliac aneurysm. Following investigation by computerized tomographic angiography and catheter angiography, a 79-year-old man was found to have a markedly tortuous iliac system, with a left common iliac artery aneurysm that measured 48 mm in maximal diameter. Due to the patient’s age and comorbidities the surgical opinion was that conventional open repair was not suitable. However, due to the tortuous nature of the aneurysm and iliac vessels, standard endovascular repair, using either a bifurcated or an aorto-uni-iliac stent graft, was also not possible. A combined approach was used by embolizing the ipsilateral internal iliac artery using coils and excluding the aneurysm using two AVP2 occlusion devices, followed by femorofemoral crossover grafting. Total aneurysm occlusion was achieved using this method and this allowed the patient to have a much less invasive surgical procedure than with conventional open repair of common iliac aneurysms, thus avoiding potential comorbidity and mortality.

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Authors and Affiliations

  1. Department of Radiology, University Hospital of North Staffordshire, City General Hospital, Russell Building, Newcastle Road, Stoke-on-Trent, 8 Meaford Avenue, Stone, Staffordshire, ST15 8LT, UK

    Nicholas J. Coupe, Lynn Ling, Mark G. Cowling & John R. Asquith

  2. Keele University School of Medicine, Keele, Staffordshire, UK

    Mark G. Cowling

  3. Department of Surgery, University Hospital of North Staffordshire, City General Hospital, Newcastle Road, Stoke-on-Trent, Staffordshire, UK

    Gregory B. Hopkinson

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  1. Nicholas J. Coupe
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  2. Lynn Ling
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  3. Mark G. Cowling
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  4. John R. Asquith
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  5. Gregory B. Hopkinson
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Correspondence to Nicholas J. Coupe.

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Coupe, N.J., Ling, L., Cowling, M.G. et al. Treatment of a Common Iliac Aneurysm by Endovascular Exclusion Using the Amplatzer Vascular Plug and Femorofemoral Crossover Graft. Cardiovasc Intervent Radiol 32, 772–775 (2009). https://doi.org/10.1007/s00270-009-9520-z

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  • DOI: https://doi.org/10.1007/s00270-009-9520-z

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