{"title":"Retrograde embolization of internal iliac artery aneurysms that enlarged after proximal ligation: A report of 5 patients","authors":"","doi":"10.1016/j.radcr.2024.09.011","DOIUrl":null,"url":null,"abstract":"<div><div>The transarterial approach is generally feasible for endovascular treatment of internal iliac artery aneurysms (IIAAs). However, this approach becomes difficult in patients who have undergone exclusion surgery (proximal ligation). We report our experience of performing transcatheter arterial embolization (TAE) using a retrograde approach from the deep femoral artery (DFA) for IIAAs that had enlarged after exclusion surgery. This case series includes 5 male patients (mean age, 57 years; range, 66-81 years) who underwent TAE of IIAAs between March 2015 and March 2024. The procedures were performed at a mean of 47 months (range, 33-108 months) after aortoiliac repair. Preoperative contrast-enhanced computed tomography (CT) or CT during aortography was performed before TAE in all cases to evaluate the development of collateral pathways. TAE was performed via the DFA using a retrograde approach with coils and cyanoacrylate glue in all cases. The procedure was technically successful in all 5 patients (100%). Intra-aneurysmal packing and embolization of the branched vessel was performed in all cases. The follow-up ranged from 6 to 66 months. All patients developed gluteal claudication but no major complications occurred during the follow-up period. No cases of aneurysm dilatation have been recorded to date. In conclusion, retrograde TAE of excluded IIAAs was a feasible and effective treatment in these 5 patients, after evaluating the development of collateral pathways on pretreatment contrast-enhanced CT.</div></div>","PeriodicalId":53472,"journal":{"name":"Radiology Case Reports","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1930043324009580/pdfft?md5=bc4722f25e77992dc684380e1a63ef88&pid=1-s2.0-S1930043324009580-main.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Radiology Case Reports","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1930043324009580","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
Abstract
The transarterial approach is generally feasible for endovascular treatment of internal iliac artery aneurysms (IIAAs). However, this approach becomes difficult in patients who have undergone exclusion surgery (proximal ligation). We report our experience of performing transcatheter arterial embolization (TAE) using a retrograde approach from the deep femoral artery (DFA) for IIAAs that had enlarged after exclusion surgery. This case series includes 5 male patients (mean age, 57 years; range, 66-81 years) who underwent TAE of IIAAs between March 2015 and March 2024. The procedures were performed at a mean of 47 months (range, 33-108 months) after aortoiliac repair. Preoperative contrast-enhanced computed tomography (CT) or CT during aortography was performed before TAE in all cases to evaluate the development of collateral pathways. TAE was performed via the DFA using a retrograde approach with coils and cyanoacrylate glue in all cases. The procedure was technically successful in all 5 patients (100%). Intra-aneurysmal packing and embolization of the branched vessel was performed in all cases. The follow-up ranged from 6 to 66 months. All patients developed gluteal claudication but no major complications occurred during the follow-up period. No cases of aneurysm dilatation have been recorded to date. In conclusion, retrograde TAE of excluded IIAAs was a feasible and effective treatment in these 5 patients, after evaluating the development of collateral pathways on pretreatment contrast-enhanced CT.
期刊介绍:
The content of this journal is exclusively case reports that feature diagnostic imaging. Categories in which case reports can be placed include the musculoskeletal system, spine, central nervous system, head and neck, cardiovascular, chest, gastrointestinal, genitourinary, multisystem, pediatric, emergency, women''s imaging, oncologic, normal variants, medical devices, foreign bodies, interventional radiology, nuclear medicine, molecular imaging, ultrasonography, imaging artifacts, forensic, anthropological, and medical-legal. Articles must be well-documented and include a review of the appropriate literature.