In Situ Laser Fenestration With Coil Embolization of Expanding Internal Iliac Artery Aneurysm Following Previous Stent Graft Coverage

Abstract

Aneurysmal expansion of the internal iliac artery (IIA) can be treated with coil embolization and endograft coverage. In this case, the IIA orifice was covered with an endograft without embolization of branch vessels, which resulted in persistent IIA aneurysm expansion. Prior vessel coverage limited the endovascular options. We describe the use of in situ laser fenestration of the iliac limb of a prior endograft to create temporary access for coil embolization of the enlarging IIA aneurysm.