Exclusion of an Internal Iliac Artery Aneurysm Using Stacked Aorto-uni-iliac Converters over a Femoro-femoral Pullthrough Wire

Introduction

An endovascular solution for treating internal iliac artery aneurysms (IIAAs) with tortuous iliac anatomy and intraprocedural complications is presented.

Report

An 85-year-old male presented with a 7-cm left IIAA causing hydronephrosis. Following inability to deploy a standard aorto-uni-iliac converter and subsequent iliac dissection, two low-profile aorto-uni-iliac converters were deployed from the external to common iliac artery over a femoro-femoral pullthrough wire, achieving a stacked configuration and successful aneurysm exclusion.

Discussion

Iliac artery tortuosity may preclude successful iliac coverage and predispose to dissection. A pullthrough wire allows arterial straightening; use of flexible low profile devices facilitates procedural success.