Complications of Endovascular Management of Isolated Internal Iliac Artery Aneurysm

The isolated internal iliac artery aneurysm is rare, but can be fatal if non-diagnosed. Endovascular treatment of these aneurysms, ideally with exclusion of the sac from antegrade and retrograde perfusion, provides a minimally invasive alternative that avoids the direct operative morbidity. We present a case of a patient treated with embolization with coils of an aneurysm of the left internal iliac artery. Then, 6 months after the procedure, the patient suffered from recurrence of abdominal pain. CT scan confirmed patency of the aneurysmal sac. Therefore, he underwent second endovascular exclusion by an external iliac artery stentgraft by ipsilateral femoral access. In the angiography post-implantation, an endoleak was diagnosed. So, a second distal stentgraft was implanted in the external iliac artery. After implantation, a total exclusion of the aneurysm was obtained. The follow-up is now 3 months. The patient is asymptomatic.