• Abstracts from SVS and Affiliated Societies
• Images and Cases
• FDA Announcements
• Clinical Trials
• Clinical Guidelines
• Bookstore
• Vascular Specialist newspaper

Home > Medical Professionals > Full Index of Images In Vascular Disease > Embolization of an Internal Iliac Artery Aneurysm

Embolization of an Internal iliac Artery Aneurysm.

Irfan I. Galaria M.D.
Mark G. Davies, M.D., Ph.D.
University of Rochester

A 82 yr old male presented with non specific pain in his right lower quadrant.  There is a previous history of a technically difficult aortic aneurysm repair with placement of an aorto- right common iliac and left common femoral bypass 10 years previously at an outside institution.   He has significant coronary artery disease with an ejection fraction of under 20% and oxygen dependent chronic obstructive airways disease. 

Duplex imaging and CT scanning demonstrated a right 5 cm internal iliac artery aneurysm which was not apparent on a CT scan 5 years ago.  The patient underwent an arteriogram, which confirmed a 5cm internal iliac artery aneurysm with an adequate neck (Figure 1). 

Figure 1  The initial angiogram shows the right bifurcation of the common iliac artery into the external (EIA) and internal iliac (IIA) arteries. The right limb of the aortic bifurcated graft is anastomosed to this area. There is an internal iliac aneurysm originating from the internal iliac artery (arrow).

A retrograde ipsilateral approach was undertaken and the aneurysm was successfully coil embolized (Figure 2A) and the ostium covered with a PTFE cover Stent (Viabahn, WL Gore Associates, Figure 2B). 

Figure 2  (A).This angiogram shows a catheter in the neck of the aneurysm sac (arrow) and multiple coils stacked into the internal iliac aneurysm sac (asterisk). (B) On this angiogram, there is a PTFE covered stent  (arrow) occluding the ostium of the internal iliac artery with exclusion of the internal iliac artery aneurysm (asterisk).

The final technical result was excellent (Figure 3).  The patient made an uneventful recovery.  At six and twelve months, the patient was asymptomatic and both duplex imaging and CT scanning confirmed occlusion of the internal iliac artery aneurysm.  Coil embolization and exclusion is a successful approach for internal iliac artery aneurysms in a high risk patient.

Figure 3  The completion angiogram shows exclusion of the internal iliac artery aneurysm with no contrast identified within the aneurysm sac.