Abstract
The endovascular exclusion of an isolated iliac artery aneurysm is recognized as a safe and favorable alternative to open surgical repair, with low associated morbidity and mortality. It has particular advantages in the treatment of internal iliac artery aneurysm (IIAA) given the technical difficulties associated with open surgical repair deep within the pelvis. We describe the use of customized tapered stent-grafts in the exclusion of wide-necked IIAA in five male patients considered high-risk for conventional surgical repair, in whom the common and external iliac artery morphology precluded the use of standard endovascular devices. In each case, IIAA outflow was selectively embolized and the aneurysm neck excluded by placement of a customized tapered stent-graft across the internal iliac artery origin. This technique was extremely effective, with 100% technical success, no serious associated morbidity, and zero mortality. In all five patients sac size was stable or reduced on computed tomography follow-up of up to 3 years (mean, 24.4 months), with a primary patency rate of 100%. We therefore advocate the use of customized tapered stent-grafts as a further endovascular option in the management of IIAA unsuitable for conventional endovascular repair.
Similar content being viewed by others
References
Lucke B, Rea MH (1921) Studies on aneurysm 1. General statistical data on aneurysm. JAMA 77:935–940
Soury P, Brisset D, Gigou F et al (2001) Aneurysms of the internal iliac artery: management strategy. Ann Vasc Surg 15:321–325
Dix FP, Titi M, Al-Khaffaf H (2005) The isolated internal iliac artery aneurysm—a review. Eur J Vasc Endovasc Surg 30:119–129
Parry DJ, Kessel D, Scott DJA (2001) Simplifying the internal iliac artery aneurysm. Ann R Coll Surg Eng 83:302–308
Richardson JW, Greenfield LJ (1998) Natural history and management of iliac aneuruysms. J Vasc Surg 8:165–171
McCready RA, Pairolero PC, Gilmore JC et al (1983) Isolated iliac artery aneurysms. Surgery 93:688–693
Brin J, Busuttil RW (1982) Isolated hypogastric artery aneurysms. Arch Surg 117:1329–1333
Strompouli E, Nassef A, Loosemore T et al (2007) The endovascular management of iliac artery aneurysms. CardioVasc Interv Radiol 30:1099–1104
Boules TN, Selzer F, Stanziale SF et al (2006) Endovascular management of isolated iliac artery aneurysms. J Vasc Surg 44:29–37
Tielliu IF, Verhoeven EL, Zeebregts CJ et al (2006) Endovascular treatment of iliac artery aneurysms with tubular stent-graft: mid-term results. J Vasc Surg 43:440–445
Dorros G, Cohn JM, Jaff MR (1997) Percutaneous endovascular stent-graft repair of iliac artery aneurysms. J Endovasc Surg 4:370–375
Hollis HW Jr, Luethke JM, Yakes WF et al (1994) Percutaneous embolisation of an internal iliac artery aneurysm: technical considerations and literature review. J Vasc Interv Radiol 5:449–451
Mori M, Sakamoto I, Morikawa M et al (1999) Transcatheter embolisation of internal iliac artery aneurysms. J Vasc Interv Radiol 10:591–597
Battaglia L, Morucci M, Bartolucci R et al (1998) Percutaneous embolisation of an isolated hypogastric artery aneurysm. A case report. J Cardiovasc Surg 39:761–763
Rayt HS, Bown MJ, Lambert KV et al (2008) Buttock claudication and erectile dysfunction after internal iliac artery embolization in patients prior to endovascular aortic aneurysm repair. CardioVasc Interv Radiol [Epub ahead of print; PMID: 18338212]
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Haslam, J.E., Hardman, J., Horrocks, M. et al. Customized Tapered Stent-Grafts in the Endovascular Management of Internal Iliac Artery Aneurysms: A Useful Adjunct to Conventional Endovascular Options. Cardiovasc Intervent Radiol 32, 139–144 (2009). https://doi.org/10.1007/s00270-008-9425-2
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00270-008-9425-2