Endovascular treatment of ruptured iliac aneurysm previously treated by endovascular means.

Abstract

A patient with a ruptured iliac aneurysm was admitted to the Emergency Department in hypovolemic shock. He had previously undergone surgical treatment for an infrarenal abdominal aortic aneurysm, which was managed with a terminal-terminal Dacron tube graft. Subsequently, he developed two iliac aneurysms, which were treated endovascularly with two wall-grafts in the right and one wall-graft in the left iliac arteries. He suffered chronic renal failure and arterial hypertension. Contrast-enhanced computed tomography showed rupture of the right iliac aneurysm and dislocation of the two wall-grafts. He was treated in an emergency situation with the implantation of an iliac endograft that bridged the two wall-grafts, which resulted in hemostasis and stabilization of his condition. Five days later, in an elective surgical situation, he was treated with the implantation of an aorto-uni-iliac endograft combined with a femoral-femoral bypass. He was discharged 5 days later in good condition. At the 4 year follow-up visit, the endoprosthesis remained in place with no evidence of an endoleak. In conclusion, overlapping of endografts should be avoided, if possible. Strict surveillance of the endovascularly treated patient remains mandatory.

• Authors: Ilias Dalainas, Giovanni Nano, Silvia Stegher, Paolo Bianchi, Giovanni Malacrida, Domenico G Tealdi
• Journal: Cardiovascular and interventional radiology (Cardiovasc Intervent Radiol) 2008 Mar-Apr Vol. 31 Issue 2 Pg. 394-7 ISSN: 1432-086X [Electronic] United States
• PMID: 17086456 (Publication Type: Case Reports, Journal Article)

Chemical References

• Contrast Media

Topics

• Aged
• Aneurysm, Ruptured (diagnostic imaging, therapy)
• Angiography
• Blood Vessel Prosthesis Implantation (methods)
• Contrast Media
• Diagnosis, Differential
• Humans
• Iliac Aneurysm (diagnostic imaging, therapy)
• Male
• Radiography, Interventional