Corona Mortis Artery as a Cause of a Type II Endoleak in an Internal Artery Aneurysm

Abstract

The present communication reports a rare cause of a type II endoleak in a patient treated for an isolated internal iliac artery (IIA) aneurysm. A 70-year-old patient underwent open surgical aortobiiliac graft placement in 1995. On follow-up computed tomographic (CT) angiography in 2005, the patient was found to have a type I right IIA aneurysm 94 × 91 mm in size, with its origin commencing at the bifurcation of the IIA (neck diameter measuring 8 mm) to involve the posterior and anterior divisions. This was embolized with an AMPLATZER Vascular Plug (AGA Medical, Golden Valley, Minnesota) and coils within the distal IIA and its branches, followed by an 18-mm × 55-mm Zenith stent-graft (Cook, Cork, Ireland) deployed in the right common iliac artery, across the orifice of the IIA. A 2-year follow-up CT angiogram demonstrated a persistent type II endoleak into the right IIA aneurysm, with an increase in the aneurysm sac size from 94 × 91 mm to 103 × 97 mm. Branches of the inferior epigastric artery appeared to perfuse the aneurysm (Fig 1). The patient subsequently underwent embolization of the aneurysm sac.