Internal Iliac Artery Aneurysm Research Articles

Duplex Scanning for Detection and Follow-Up of Iliac Artery Aneurysms and Pseudoaneurysm Amenable to Endovascular Therapy

Duplex ultrasound can be a valuable tool in detecting potentially life-threatening iliac artery aneurysms and pseudoaneurysms amenable to endovascular therapy. Four patients were found to have aneurysms other than abdominal aortic aneurysms, which were treated successfully with endovascular exclusion techniques. These included a 5.4 x 5.1-cm pseudoaneurysm arising from the distal anastomotic site of a previous aortic aneurysmorrhaphy; a 7.8 x 6.4-cm right common iliac artery aneurysm with an associated arteriovenous fistula that caused high-output heart failure, and a 4.1 x 5.0-cm aneurysm of the left internal and common iliac artery in a patient who had previous surgical repair of an aortic aneurysm with a bifurcated graft. A patient with a 7.5-cm aneurysm of the internal iliac artery also was treated, but the initial ultrasound diagnosis was made by a referring hospital. Treatment methods included placement of bifurcated endografts (two cases), use of a covered stent (one case), and use of a single iliac component from an aortic endograft (one case). Three internal iliac arteries were embolized with coils. In one patient, subsequent duplex surveillance identified a stenosis within a covered stent. This was treated with placement of a balloon-expandable stent.

Stent-grafting combined with transcatheter embolization for a ruptured isolated hypogastric artery aneurysm

孤立的下腹部的动脉动脉瘤(HAA ) 的破裂很少被遇到并且与高死亡率被联系。常规外科不能容易完成远侧的控制并且可以引起实质的血损失，产出高起作用的病态和死亡。OnMarch 17， 2005，我们由使用与 transcatheter embolization 相结合的接枝 endovascularstent 成功地与如此的疾病对待一个病人。

Endovascular Exclusion of Symptomatic Bilateral Common Iliac Artery Aneurysms With Preservation of an Aneurysmal Internal Iliac Artery Via a Reverse-U Stent-Graft

To report a technique to maintain flow to an aneurysmal internal iliac artery (IIA) when treating bilateral common iliac artery (CIA) aneurysms with an aortomonoiliac stent-graft and femorofemoral bypass. First, an external iliac artery (EIA) to IIA endograft is placed distal to the IIA aneurysm then the contralateral IIA is embolized with coils. An aortomonoiliac stent-graft extending to the contralateral EIA is placed, and the procedure is completed with a femorofemoral bypass. Endovascular treatment of bilateral CIA aneurysms and combined with a unilateral IIA aneurysm is a technically demanding procedure. An endovascular repair with retrograde (reverse-U stent-graft) hypogastric artery preservation can be considered a first choice until the use of branched iliac stent-grafts becomes more widespread.

Hematuria por rotura de aneurisma ilíaco-ureteral

Ureteral-iliac artery fistula is a rare condition. We perform a bibliographic review and report a case of ureter-iliac artery fistula reviewing its major differential diagnosis. This case-study describes a patient with massive hematuria that presented a ureter-iliac artery fistula secondary to spontaneous rupture of an internal iliac artery aneurysm. 86 -year-old male patient with history of previous surgery for aneurysm and ureteral catheterization. This difficult diagnosis should be thought of in a patient with massive macroscopic hematuria and previous vascular surgery. The treatment is always surgery.

Bilateral compressive lumbosacral plexopathy due to internal iliac artery aneurysms

Bilateral compressive lumbosacral plexopathy due to internal iliac artery aneurysms

Endovascular coiling of ruptured internal iliac artery aneurysm in a leukemia patient-a case report

AbstractEndovascular occlusion of isolated internal iliac artery aneurysm is a safe and effective procedure. We report a case of coiling of a ruptured Internal Iliac artery aneurysm in a leukaemia patient with intramuscular haematoma achieving an excellent immediate result and no recanalisation on 6 month follow up.

Spontaneous Rupture of Hypogastric Artery Aneurysm into the Bladder: A Case Report and Review of the Literature

Isolated internal iliac artery (hypogastric) aneurysms are rare. The incidence is less than 0.9%. They are usually asymptomatic. Symptoms can be due to compression of adjacent pelvic structures such as the bladder, ureters, and colon. Rupture of hypogastric artery aneurysms into the bladder has rarely been reported and, when present, is associated with prior abdominal instrumentation or trauma. There is one case where an arteriovesicular fistula formed spontaneously without any instrumentation or trauma, similar to our case. We describe an unusual case of an 81-year-old male with spontaneous rupture of a hypogastric artery aneurysm into the urinary bladder presenting as gross hematuria. This case illustrates the importance of a high index of suspicion in diagnosis and early treatment to reduce morbidity and mortality.

An Isolated Infected Internal Iliac Artery Aneurysm Due to Anaerobic Bacteria

An Isolated Infected Internal Iliac Artery Aneurysm Due to Anaerobic Bacteria

Experiences with cadaver renal allograft contamination before transplantation

Microbial contamination occurred in 23 (13 per cent) of 177 cadaver donor kidneys prior to renal transplantation. In 16 cases there were no complications directly attributable to the organisms recovered from the preservation media. Three patients developed perinephric infections associated with renal artery anastomotic disruption and required emergency transplant nephrectomy. A fourth patient developed renal artery stenosis and a hypogastric artery aneurysm that required correction 6 months later with preservation of renal allograft function. In 3 cases no follow-up information was available. None of the 154 uncontaminated kidneys developed arterial disruption or aneurysm. Candida albicans and Pseudomonas aeruginosa infections were responsible for the nearly disastrous arterial disruptions and possibly the hypogastric arterial aneurysm. These findings demonstrate the importance of bacteriological surveillance of perfusion media to detect nosocomial infection, to guide antibiotic chemotherapy and to direct surgical management of septic complications. In our experience contamination was not necessarily incompatible with long term satisfactory results; however, when complications did occur they were serious. It is likely that the size of the microbial inoculum, the patient's immune competence and the protective effect of antibiotic therapy administered to the donor and recipient affected the eventual outcome.

Endovascular Treatment of an Internal Iliac Artery Aneurysm Using a Nitinol Vascular Occlusion Plug

To report endovascular occlusion of an internal iliac artery (IIA) aneurysm with an Amplatz nitinol vascular occlusion plug. A 71-year-old asymptomatic man who had previously undergone open aortic aneurysm repair presented for annual follow-up. A bifurcated Dacron graft had been inserted 12 years ago from the infrarenal aorta to the left common femoral artery and the right common iliac artery. The left common iliac artery was ligated proximally, and the left external iliac artery (EIA) provided retrograde flow into the IIA. Magnetic resonance imaging (MRI) revealed a 7.4-cm aneurysm of the left IIA. After transfemoral calibrated catheter angiography was performed, the proximal EIA was occluded with an Amplatz nitinol vascular occlusion plug. In addition, microcoils were placed distal to the vascular plug to achieve complete thrombosis of the vessel. One day after treatment, the patient was discharged free of symptoms after MRI had shown complete obliteration of the IIA aneurysm. At 6 months, the patient was free from symptoms, and angiography confirmed exclusion of the IIA aneurysm. This case illustrates the technical feasibility and successful short-term follow-up of a novel embolization approach to IIA aneurysms in patients with an aortofemoral graft.

Simultaneous Iliocolic and Ilioureteric Fistulae as a Complications of Coil Embolization for Treatment of Isolated Internal Iliac Artery Aneurysm

This report describes an unusual set of complications of the use of coil embolization and covered stent (CECS) occlusion of a large internal iliac artery aneurysm (IIAA). An 82-year-old man presented with symptoms of left ureteric obstruction secondary to compression by a left IIAA. This was treated by CECS. Twelve months later, the patient represented with recurrent non-specific septic episodes, urinary infections, diarrhoea and rectal bleeding. He was subsequently shown to have a fistula between the left ureter, the sigmoid colon and the sac of the aneurysm. He underwent surgical repair of the three-way fistula with a successful outcome.

Simultaneous Iliocolic and Ilioureteric Fistulae as a Complications of Coil Embolization for Treatment of Isolated Internal Iliac Artery Aneurysm

This report describes an unusual set of complications of the use of coil embolization and covered stent (CECS) occlusion of a large internal iliac artery aneurysm (IIAA). An 82-year-old man presented with symptoms of left ureteric obstruction secondary to compression by a left IIAA. This was treated by CECS. Twelve months later, the patient represented with recurrent non-specific septic episodes, urinary infections, diarrhoea and rectal bleeding. He was subsequently shown to have a fistula between the left ureter, the sigmoid colon and the sac of the aneurysm. He underwent surgical repair of the three-way fistula with a successful outcome.

Bleeding Prolapsed Hemorrhoids as a Presentation of Ruptured Internal Iliac Artery Aneurysm: Report of a Case

Internal iliac artery aneurysms (IIAAs) are rare and their concealed location in the pelvis presents a diagnostic challenge. We report a case of a 79-year-old man who presented 12 years after an abdominal aortic aneurysm repair, with signs of prolapse, bleeding, hemorrhoids, and a deep vein thrombosis. His condition rapidly deteriorated, with the development of acute renal failure and obvious perianal and perineal ecchymoses, within a few days. Abdominal ultrasound and computed tomography showed a ruptured IIAA. His renal function returned to normal after surgical decompression of the aneurysm.

Ischemia a New Cause of Colovesical Fistula Resulting from Internal Iliac Artery Aneurysm Coil Embolization

Diverticular disease is the most common cause of colovesical fistula. Colvesical fistulae are observed in postoperative settings or as a consequence of Crohn's disease. Iatrogenic fistulae are caused by surgical procedures, radiation, cancer, or infection. Other causes include foreign bodies, like swallowed chicken bones or toothpicks, in the bowel. This is the first report of an endovascular coil causing a colovesical fistula by an ischemic mechanism. A 76-year-old man with a contained rupture of a 12 cm left internal iliac artery aneurysm was treated endovascularly with coil embolization and stent placement. He had a right hemicolectomy for a colon cancer; prostate cancer treated with hormonal therapy and had undergone a Billroth II anastamosis with vagotomy for PUD in the past. A colonoscopy two years ago was normal. Eleven days post procedure he had four episodes of hematochezia with a drop in his hemoglobin and hematocrit. Coagulation profile and platelet count were normal. He denied melena, hematemesis, abdominal pain or constipation. Some feces were reported inside his urinary catheter bag but no pneumaturia was reported. His vital signs were stable. Abdomen was nontender with a central surgical scar. His rectal exam showed heme positive formed stools. Abdominal CT scan revealed no extravasation of IV contrast into the gastrointestinal tract or leak from the vascular stent. On colonoscopy, at 20 cm from the anal verge, a 4 cm fistulous opening was seen with visualization of urinary bladder wall. Cystoscopy confirmed a large fistula between the bladder and rectum at the level of the trigone distal to the ureteral orifices. During surgery a wire from the iliac artery aneurysm coils was seen sitting in the bladder causing a vesiculoaneurysmal fistula as well. The patient made an uneventful recovery post-surgical repair of the fistulas and removal of the vascular coils. Patients with colovesical fistulas may have suprapubic pain, irritative voiding symptoms, urinary tract infections and hematuria. Pneumaturia and fecaluria are seen in 40–60%. CT scanning of the abdomen and pelvis is the most sensitive test for detecting a colovesical fistula. Colonoscopy is helpful in determining the nature of the bowel disease. Treatment of the fistulas depends on the cause. Connections between the colon and urinary bladder can result from ischemia caused by coils placed for embolization.

Ruptured Isolated Internal Iliac Artery Aneurysm Presenting with Haematuria: A Case Report

Internal iliac aneurysms are rare and their presentation with haematuria is even rarer. This report describes a patient with a ruptured internal iliac artery (IIA) aneurysm who presented with mild right iliac fossa pain and haematuria. A computed tomography scan demonstrated a right internal iliac artery aneurysm that had ruptured into the bladder. The patient was immediately taken to theatre for IIA ligation and bladder repair. This uncommon presentation of a ruptured internal iliac artery aneurysm should be kept in mind when investigating older patients with haematuria.

Ruptured Isolated Internal Iliac Artery Aneurysm Presenting with Haematuria: A Case Report

Internal iliac aneurysms are rare and their presentation with haematuria is even rarer. This report describes a patient with a ruptured internal iliac artery (IIA) aneurysm who presented with mild right iliac fossa pain and haematuria. A computed tomography scan demonstrated a right internal iliac artery aneurysm that had ruptured into the bladder. The patient was immediately taken to theatre for IIA ligation and bladder repair. This uncommon presentation of a ruptured internal iliac artery aneurysm should be kept in mind when investigating older patients with haematuria.

Ruptured Internal Iliac Artery Aneurysm Treated by Percutaneous Transcatheter Embolisation

Ruptured internal iliac artery aneurysms (IIAA) are rare. Operative treatment carries a high morbidity and mortality while endovascular treatment offers an alternative option. We report a case of ruptured IIAA treated successfully treated by an alternative form of percutaneous coil embolisation. Selective catheterization of all the outflow branches was impossible and the volume of the aneurysm sac precluded embolisation with conventional coils. The sac was, therefore, packed with 10cm lengths of guidewire with the central mandrel removed.

Ruptured Internal Iliac Artery Aneurysm Treated by Percutaneous Transcatheter Embolisation

Ruptured internal iliac artery aneurysms (IIAA) are rare. Operative treatment carries a high morbidity and mortality while endovascular treatment offers an alternative option. We report a case of ruptured IIAA treated successfully treated by an alternative form of percutaneous coil embolisation. Selective catheterization of all the outflow branches was impossible and the volume of the aneurysm sac precluded embolisation with conventional coils. The sac was, therefore, packed with 10cm lengths of guidewire with the central mandrel removed.

Treatment of infrarenal aortic aneurysm by minimally invasive retroperitoneal approach: Use of a video-assisted technique

We propose a technique for treating abdominal aortic aneurysm in which first a minilaparotomy (retroperitoneal) is performed to make a conventional arterial dissection; then, video assistance is used to control the left lumbar arteries and to make the aortic anastomosis. This technique can be performed with no significant laparoscopic capability.The patient was installed in a 20-degree right lateral decubitus. A transverse left 8- to 10-cm abdominal incision was made, followed by separation of the muscular structures. Retroperitoneal control of the proximal aortic neck and of both common iliac arteries was obtained by digital and instrumental dissection. A 30-degree laparoscope was then introduced through a 8- to 12-mm trocar and provided the light and magnification that facilitated the dissection of the posterior wall of the aortic neck and of the left flank of the aneurysm, looking for the lumbar arteries to be clipped. A suspended running suture to make the aorto-prosthetic anastomosis was facilitated by the magnification of the camera, especially during the passage of needles. Between March and September 2001, 32 patients fulfilled the anatomic conditions: an infrarenal aortic neck length of 2 cm or more, absence of hypogastric artery aneurysm, and no need for inferior mesenteric artery reimplantation. In 30 patients, the surgery was performed by using the planned minimally invasive approach, and extension of the incision was necessary in two patients.

Unilateral lower extremity paralysis after coil embolization of an internal iliac artery aneurysm

Neurologic complications after treatment of internal iliac artery (IIA) aneurysms are rare, especially if confined to one IIA. We report a patient in whom profound right lower extremity paresis developed after unilateral right IIA coil embolization for treatment of a 4-cm IIA aneurysm, despite the presence of a patent contralateral IIA. This case illustrates the important, yet unpredictable, nature of pelvic blood flow to the distal spinal cord and lumbosacral plexus and the unpredictable consequence of IIA occlusion.