Pseudoaneurysm Of Common Iliac Artery Research Articles

Vascular rescue–minimally invasive management of a post-spinal surgery fistulized ilio-iliac pseudoaneurysm: a case report

BackgroundAortoiliac injury after intervertebral disc surgery is an uncommon but potentially fatal complication. This case study emphasizes how crucial it is to identify this uncommon complication, which can manifest itself in a variety of ways, including leg oedema, heart failure, and deep vein thrombosis. This case is unique in that it presents with an uncommon post-spinal surgery complication of fistulized pseudoaneurysm of the common iliac artery and vein. This combination calls for an immediate diagnosis and careful care.Case presentationA 36-year-old female patient presented with progressively worsening orthopnea, accompanied by chest pain and palpitations. Her medical history revealed gradually increasing right lower limb swelling since three months, following a discectomy procedure for the management of lower back pain associated with a herniated lumbar disc at the L5-S1 level. Doppler ultrasonography demonstrated an arterialized flow within the right common iliac vein. Subsequent computed tomography angiography identified a pseudoaneurysm of the right common iliac artery, which had formed a fistulous connection to the right common iliac vein. This uncommon complication was likely attributable to prior disc surgery. The patient received endovascular intervention, which was executed in two primary stages: first, embolization of the right internal iliac artery was performed, followed by the exclusion of the arteriovenous fistula through the deployment of a covered stent graft within the right common iliac artery. The intervention successfully resolved both the pseudoaneurysm and the arteriovenous fistula.ConclusionsThis case report underscores the importance of considering vascular complications in patients presenting with unusual symptoms following intervertebral disc surgery, even after a significant time lapse. While both open surgical and endovascular approaches can yield good results in treating such complications, the endovascular method, as demonstrated in this case, is associated with minimal morbidity. This approach offers a less invasive alternative that can effectively manage complex vascular injuries resulting from disc surgery. Clinicians should be aware of this rare but serious complication to ensure timely diagnosis and appropriate management, potentially improving patient outcomes in similar cases.

Case Report: A Pseudoaneurysm Involving the Left Common Iliac Artery Secondary to Brucellosis: A Rare Case Report

Pseudoaneurysms of the common iliac artery caused by Brucellosis are exceedingly uncommon. Infected common iliac artery pseudoaneurysms, particularly those caused by brucellosis, are more difficult to diagnose and cure than general pseudoaneurysms. The risk of mortality is significantly high in this condition. Nonsurgical treatment of a brucellosis-induced common iliac artery pseudoaneurysm is futile, and it should be operated on as soon as feasible. Long-term and multi-course antibacterial therapy with combination antibiotics is required. For the treatment of Brucella-infected pseudoaneurysms, endovascular surgery can be both effective and safe.

Endovascular management of giant common iliac artery pseudoaneurysm after complications in simultaneous pancreas\u2013kidney transplant: a case report

BackgroundPancreatic transplantation is a definitive treatment for selected patients with insulin-dependent diabetes. It is a technically challenging surgery, and vascular complications are the most common cause of pancreatic graft failure. Although rare, pancreas transplants present higher rates of pseudoaneurysms at the vascular anastomosis than other visceral transplants. We present a case of a simultaneous pancreas–kidney transplant complicated with graft failure and common iliac artery pseudoaneurysm that was successfully treated through endovascular techniques.Case presentationA 34-year-old White woman presented with abdominal pain and a history of type 1 diabetes mellitus, end-stage renal disease, and two previous pancreas transplantation failures. The first was a simultaneous pancreas–kidney transplantation performed 7 months prior that was complicated by pancreas graft thrombosis within 1 month and required graft resection. Five months later, she underwent a second pancreas transplantation with another pancreatic graft thrombosis requiring graft resection. Abdominal angiotomography revealed a pseudoaneurysm in the right common iliac artery at the point of the previous graft anastomosis. The patient was successfully treated endovascularly with a covered stent in the common iliac artery.ConclusionStent graft implantation for the treatment of common iliac artery pseudoaneurysm as a complication of simultaneous pancreas–kidney transplantation is a safe and feasible procedure.

Gastrointestinal Bleeding Secondary to Iliac Artery Pseudoaneurysm in a Patient With Remote Pancreas Transplant: A Case Report

BackgroundVascular complications represent the most common cause of early graft failure after pancreatic transplantation (PT). Pseudoaneurysms are uncommon vascular complications that usually present within the first year post transplantation. Case ReportA 49-year-old man with history of type 1 diabetes mellitus presented for evaluation with a 2-day history of painless hematochezia. He had undergone PT 4 years prior to presentation, which failed due to acute cellular rejection after 1 year. Both extended upper endoscopy and colonoscopy did not identify an active bleeding source. After an episode of massive hematochezia, he became hemodynamically unstable with peritoneal signs noted on physical examination. An abdominal angiogram was unable to identify active hemorrhage, and the patient was transferred to the operating room for open laparotomy. Exploration revealed a right common iliac artery pseudoaneurysm eroding into the pancreatic-ileal anastomosis, which required initial digital compression for initial hemostasis. After combined endovascular procedure with ballooning and stenting of the right iliac artery, optimal hemostasis was achieved without further episodes of hematochezia. DiscussionGastrointestinal bleeding (GIB) has been reported to occur in 11% of enteric-drained PT. Even though infectious causes have been reported, culprits are more commonly associated with vascular or enteric surgical anastomosis and usually occur within the early postoperative course. Here we report an uncommon cause of GIB, a late complication of PT, and review important points associated with the management of GIB, anatomy of PT, and potential etiologies for early and late GIB in the setting of PT.

Common iliac Artery Pseudo Aneurysm as a Complication of Diagnostic Laparoscopy

Common iliac Artery Pseudo Aneurysm as a Complication of Diagnostic Laparoscopy

Graft Pseudoaneurysm Hemorrhage in a Patient With a History of an Enteric-Drained Pancreatic Transplant: A Case Report

Graft pseudoaneurysm is a rare but life-threatening complication in patients who have undergone pancreatic transplantation. While most of the reported post-pancreatic transplantation pseudoaneurysms present in the early postoperative period, late-onset pseudoaneurysms do occur, though much more rarely. We report a case of massive lower gastrointestinal hemorrhage in a 58-year-old female with a history of enteric-drained pancreatic transplant and donor duodenum anastomosis to recipient jejunum. This transplant occurred 7 years prior but 1 year prior the pancreatic graft failed as insulin-dependent diabetes mellitus recurred. Around the same time, a small bowel obstruction occurred requiring a small bowel resection with primary anastomosis. The bleeding episode began with the patient initially presenting in hypovolemic shock from hematochezia and an acute hemoglobin drop to 5.5 g/dL. Upper endoscopy was unremarkable, and colonoscopy revealed blood within the colon and the terminal ileum but no source could be identified. An abdominal angiogram and tagged RBC study were also unable to identify a source of gastrointestinal hemorrhage. CT angiogram of the abdomen revealed a mid-right common iliac artery pseudoaneurysm at the failed pancreatic graft site. Deployment of a covered stent across this vascular structure resulted in controlling the active extravasation into the small bowel lumen. Follow-up abdominal CT showed an excluded thrombosed pseudoaneurysm. In summary, we report this case to emphasize the diagnostic challenges associated with identifying this rare but life-threatening and at times late-onset complication of enteric-drained pancreatic transplant.

Endovascular treatment of right common iliac artery pseudoaneurysm with arteriovenous fistula to left common iliac vein: Long-term follow-up

We report a case of pseudoaneurysm of the right common iliac artery ruptured into the contra lateral common iliac vein as a rare complication of lumbar disc surgery. A 57-year-old lady developed severe heart failure and features of leg ischaemia on the second postoperative day after L4-L5 laminectomy with discectomy. Detection of a thrill and bruit in the lower abdomen, and evidences from abdominal aortography and multislice CT angiography led to correct diagnosis. She underwent successful endovascular treatment and remained asymptomatic with patent stent and no complications at the end of 6 years follow-up. Endovascular repair using covered stent is a safe, effective and durable method for treating pseudoaneurysm and arteriovenous fistula of iliac artery.

Percutaneous closure of pseudoaneurysm of common iliac artery with amplatzer duct occluder II

Seven-year-old boy presented with pain in right lower limb and abdomen after a fall from a bullock cart. He was referred for management of pseudoaneurysm of the right common iliac artery. After CT angiogram, the vascular surgeon opined that child was not suitable for surgical patch or graft or endovascular stenting as there was no landing zone for the stent. Hence the child was treated with transcatheter closure with two Amplatzer duct occluder II (ADO II). On follow-up the symptoms and bruit disappeared. To the best of our knowledge this is the first case of pseudoaneurysm, treated with ADO II.

Successful endovascular treatment of a ruptured gigantic pseudoaneurysm of the common iliac artery secondarily complicated by infection

We report our experience with a case of emergent endovascular treatment of a large ruptured pseudoaneurysm of the common iliac artery. A 65-year-old male was admitted to the surgical department in hypovolemic shock, due to active retroperitoneal bleeding. A computerized tomography scan with intravenous contrast revealed a ruptured gigantic pseudoaneurysm of the right common iliac artery, with a maximal diameter of 7 cm and retroperitoneal hematoma. An intraoperative angiogram revealed active extravasation through the neck of the pseudoaneurysm, which was successfully sealed with the placement of a stent graft (Medtronic Endurant(®))limb component. Infection of the pseudoaneurysm sac after one month was successfully treated with catheter drainage. No shortterm relapse occurred. Endovascular management should be part of the basic surgical armamentarium on emergent basis, since it provides a fast and safe solution, especially when a patient's co-morbitities preclude open management and hemodynamic and anatomical status allows endovascular treatment.

Endovascular repair of a common iliac pseudoaneurysm and aortic ectasia in a patient with horseshoe kidney and pancreatitis: a case report.

We present the first case of 45 year-old male with an incidental non-symptomatic right common iliac artery pseudoaneurysm with concomitant aortic ectasia in the setting of severe alcoholic pancreatitis and a horseshoe kidney diagnosed by CT and MRA. Such findings would have posed significant difficulty during an open approach precluding safe surgical repair. Therefore, an exclusion endovascular repair of the pseudoaneurysm was employed using a unibody bifurcated endovascular aortic stent-graft to good results. Although not without their complications, endovascular stent-grafts may be life saving to patients who are not candidates for conventional surgical repair. We describe the diagnosis alongside our technique of endovascular repair.

Tuberculous iliac artery aneurysm in a pediatric patient

Vascular complications of tuberculous infections are rare and occur even less frequently in the pediatric population. Tuberculous pseudoaneurysms can occur either as a result of contiguous spread from a neighboring focus-invariably infected lymph nodes-or by hematogenous spread and seeding of acid-fast bacilli that lodge in the adventitia or media via the vasa vasorum. We report a case of turberculous right common iliac artery pseudoaneurysm in a 12-year-old and review the relevant literature.

Mycotic abdominal aortic and iliac aneurysms in a 4-month-old treated with a cryopreserved homograft

A 4.4-kg, 4-month-old girl with transposition of the great vessels and coarctation of the proximal descending thoracic aorta presented 3 weeks after surgical correction with fulminant endocarditis and persistent enterococcal bacteremia, despite adequate antimicrobial coverage. Computed tomographic angiography revealed a 10-mm aortic pseudoaneurysm just distal to the superior mesenteric artery, occlusion of the right renal artery, and a 12-mm pseudoaneurysm at the aortic bifurcation extending into the left common iliac artery (A). We proceeded with surgical repair of the aneurysms through transabdominal approach. Exposure of the aorta revealed two pseudoaneurysms surrounded by a thin friable wall and a dense covering of inflammatory tissue (B, aortic and left common iliac artery pseudoaneurysm). The mycotic aneurysms were excised to clinically normal aortic wall margins. A 5-mm cryopreserved adult femoral artery homograft was implanted from the suprarenal aorta to the left distal common iliac artery, incorporating the left renal artery and the origin of the right common iliac artery (C). Cultures grew Enterococcus and coagulase-negative Staphylococcus from both aneurysms. The patient underwent repair of her congenital cardiac anomalies 1 week later. After a prolonged hospital stay, she was dismissed, feeding well and gaining weight. She returned 4.5 years later, without clinical evidence of recurrent infection, aortic narrowing, or compromise. A computed tomographic scan showed patency of the homograft, with partial calcification of the wall, minimal intimal hyperplasia, and no evidence of infection or recurrent aneurysms (D).

Fungal endocarditis with central and peripheral embolization: Case report

A 50-year-old man with a history of drug addiction was admitted to the cardiology department for aortic valve fungal endocarditis complicated by severe aortic regurgitation, cerebral infarcts and right common iliac artery pseudoaneurysm. While awaiting transfer to the cardiothoracic surgery department, the patient presented acute arterial ischemia of the left leg, and distal left patellofemoral embolectomy was successfully performed. The patient was then transferred to the cardiothoracic center and the aortic valve was replaced by a bioprosthetic valve. After 14 days he was referred for vascular surgery, where the four-month hospitalization was complicated by left leg amputation. Four months after discharge, the patient was admitted to the emergency department for recurrent fungal endocarditis complicated by multiple renal and splenic infarcts and celiac trunk embolization. He was transferred to the cardiothoracic surgery department, but suffered cardiac arrest before surgical intervention.

Endocardite fúngica com embolização central e periférica: um caso clínico

A 50-year-old man with a history of drug addiction was admitted to the cardiology department for aortic valve fungal endocarditis complicated by severe aortic regurgitation, cerebral infarcts and right common iliac artery pseudoaneurysm. While awaiting transfer to the cardiothoracic surgery department, the patient presented acute arterial ischemia of the left leg, and distal left patellofemoral embolectomy was successfully performed. The patient was then transferred to the cardiothoracic center and the aortic valve was replaced by a bioprosthetic valve. After fourteen days he was referred for vascular surgery, where the four-month hospitalization was complicated by left leg amputation. Four months after discharge, the patient was admitted to the emergency department for recurrent fungal endocarditis complicated by multiple renal and splenic infarcts and celiac trunk embolization. He was transferred to the cardiothoracic surgery department, but suffered cardiac arrest before surgical intervention.

Spontaneous development of pseudo-aneurysm of common iliac artery revealing Behçet's disease

Spontaneous development of pseudo-aneurysm of common iliac artery revealing Behçet's disease

Bifurcated Endograft Repair of Ilio-iliac Arteriovenous Fistula Secondary to Lumbar Diskectomy

Ilio-iliac arteriovenous (AV) fistula is a rare complication after lumbar diskectomy. Endovascular repair of such fistulas is a growing trend in vascular surgery. This is a case report of an endovascular exclusion of an ilio-iliac AV fistula in a 51-year-old male. This man presented with high-output congestive heart failure and ascites. The AV fistula was discovered 17 years after a lumbar diskectomy. Computed topography (CT) revealed a right common iliac artery pseudoaneurysm connecting to the left common iliac vein. The fistula was repaired using a bifurcated Gore Excluder endograft. There were follow-up CT scans at 6 and 10 months confirming exclusion of the AV fistula. Endovascular AV fistula repair offers a safe, effective method for managing ilio-iliac AV fistulas.

Iliac vascular complication after spinal surgery: immediate endovascular repair following CT angiographic diagnosis

Iliac arterial injuries are rare but important complications that can develop after spinal surgery. The presentation of these injuries is usually late, with symptoms such as leg swelling or cardiac failure. However, acute massive bleeding may be a sign of early presentation as in our patient. Herein, we present a case of life-threatening bleeding with early computed tomography angiographic diagnosis of common iliac artery pseudoaneurysm and iliac arteriovenous fistula secondary to spinal surgery which was successfully managed by endovascular stent graft treatment.