CardioVascular and Interventional Radiology

, Volume 42, Issue 2, pp 313–316 | Cite as

Unusual Access for the Treatment of Iliac Artery Aneurysm in Association with Type II Endoleak After Endovascular Repair of an Aortoiliac Aneurysm

  • Rohit Philip ThomasEmail author
  • Martin Köcher
  • Marie Černa
  • Petr Utíkal
Case Report


Internal iliac artery aneurysms (IIAAs), although rare, are associated with a significant risk of mortality, if they rupture. Endovascular approach with exclusion of the aneurysm sac from antegrade and retrograde perfusion is proved to be a feasible treatment option. However, this option is not always technically possible with a preexisting endovascular aneurysm repair (EVAR) or surgical aortoiliac reconstruction with ligation of internal iliac artery origin. We report another safe treatment option of an enlarging IIAA associated with a type II endoleak after EVAR and a standard endovascular treatment was not possible. The access to the aneurysm sac was achieved retrograde via percutaneous access to the superior gluteal artery under fluoroscopy followed by treatment with embolization of the inflow and outflow vessels.


Internal iliac artery aneurysm Type II endoleak Percutaneous access 


Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Human and Animal Rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Consent for Publication

Consent for publication was obtained for every individual person’s data included in the study.


  1. 1.
    Perry DJ, Kessel D, Scott D. Simplifying the internal iliac artery aneurysm. Ann R Coll Surg Engl. 2001;83:302–8.Google Scholar
  2. 2.
    Million A, Paquet Y, Ahmed SB, Pinel G, Rosset E, Lermusiaux P. Midterm outcomes of embolization of internal iliac artery aneurysms. Eur J Vasc Endovasc Surg. 2013;45:22–7.CrossRefGoogle Scholar
  3. 3.
    Mori M, Sakamoto I, Morikawa M, Kozhaki S, Makino K, Matsunaga N, et al. Transcatheter embolization of internal iliac artery aneurysms. J Vasc Interv Radiol. 1999;10:591–7.CrossRefGoogle Scholar
  4. 4.
    Henry M, Amor M, Henry I, Tzvetanov K, Buniet JM, Amicabile C. Endovascular treatment of internal iliac artery aneurysms. J Endovasc Surg. 1998;5:345–8.CrossRefGoogle Scholar
  5. 5.
    Dix FP, Tixi M, Al-Khaffof H. The isolated internal iliac artery aneurysm—a review. Eur J Vasc Endovasc Surg. 2005;30:119–29.CrossRefGoogle Scholar
  6. 6.
    Deb B, Benjamin M, Comerota AJ. Delayed rupture of an internal iliac artery aneurysm following proximal ligation for abdominal aortic aneurysm repair. Ann Vasc Surg. 1992;6:537–40.CrossRefGoogle Scholar
  7. 7.
    Wolf F, Loewe C, Cejna M, Schroder M, Rand T, Kettenbach Dirisamer A, Lammer J, Funovics M. Endovascular management performed percutaneously of isolated iliac artery aneurysms. Eur J Radiol. 2008;65(3):491–7.CrossRefGoogle Scholar
  8. 8.
    Hsu MY, Su TW, Su IH, Ko PJ, Chu SY. Management of type II endoleak from internal iliac artery immediately after endovascular aneurysm repair. Vasc Endovascular Surg. 2017;51(1):47–50.CrossRefGoogle Scholar
  9. 9.
    Rogoff PA, Stock JR. Percutaneous transabdominal embolization of an iliac artery aneurysm. Am J Roentgenol. 1985;145(6):1258–60.CrossRefGoogle Scholar
  10. 10.
    Gemmete JJ, Arabi M, Cwikiel WB. Percutaneous transosseous embolization of internal iliac artery aneurysm type II endoleak: report of two cases. Cardiovasc Intervent Radiol. 2011;34(Suppl 2):S122–5.CrossRefGoogle Scholar
  11. 11.
    Magishi K, Izumi Y, Tanaka K, Shimizu N, Uchida D. Surgical access of gluteal artery to embolise a previously excluded, expanding internal iliac artery aneurysms. J Vasc Surg. 2007;45(2):387–90.CrossRefGoogle Scholar
  12. 12.
    Parlani G, Simonte G, Fiorucci B, De Rango P, Isernia G, Fischer MJ, Rebonato A. Bilateral staged computed tomography guided gluteal artery puncture for internal iliac embolization in a patient with type II endoleak. Ann Vasc Surg. 2016;36:293.e5–10. (Epub 2016 Jul 15).CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2018

Authors and Affiliations

  • Rohit Philip Thomas
    • 1
    Email author
  • Martin Köcher
    • 2
  • Marie Černa
    • 2
  • Petr Utíkal
    • 3
  1. 1.Department of Diagnostic and Interventional Radiology, UKGM University Hospital MarburgPhilipps-University MarburgMarburgGermany
  2. 2.Department of Radiology, University Hospital OlomoucPalacky UniversityOlomoucCzech Republic
  3. 3.Department of Surgery II, Vascular and Transplantation Surgery, University Hospital OlomoucPalacky UniversityOlomoucCzech Republic

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