Non-aneurysmatic rupture of an iliac artery presenting as pseudoaneurysm followed by endovascular treatment.

Abstract

A 70-year-old male presented in the emergency department of our hospital complaining of left flank pain of acute onset. The patient was a hypertensive, heavy smoker and his medical history revealed no previous episode of renal colic pain. Palpable pulses were detected along the entire length of both lower limbs. Since the patient was hemodynamically stable and the laboratory assessment was normal, the patient was admitted to the orthopedic department. However, since the pain did not subside, magnetic resonance imaging with contrast was conducted, revealing a 6-cm wide pseudoaneurysm attributed to a ruptured atherosclerotic plaque or penetrating atherosclerotic ulcer of the left common iliac artery (Panel A, posterior view). Accordingly, the patient was immediately transferred to the angiographic suite, where the aforementioned finding was confirmed (Panel B-1). Successful endovascular treatment was performed with insertion of two balloon-expandable stent-grafts (6×59 mm Advanta V12; Atrium Medical Corporation, Hudson, NH, USA) through percutaneous bilateral femoral access. Deployment was Images in Vascular Medicine