HYBRID TREATMENT OF INFRARENAL ABDOMINAL AORTIC ANEURYSM WITH INVOLVEMENT OF THE COMMON ILIAC ARTERY – CASE REPORT

Abstract

Introduction. Endovascular abdominal aortic aneurysm repair (EVAR) has been extensively used in the treatment of abdominal aortic aneurysms (AAA). Over time, the indications have progressively expanded, and sometimes, when the aneurysm involves the iliac axis, exclusion of the internal iliac artery is necessary to ensure an appropriate landing zone.

Case presentation. A 63-year-old patient diagnosed with an infrarenal aortic aneurysm involving the right common iliac artery, confirmed by CT angiography. The decision was made to perform endovascular abdominal aortic aneurysm repair with extension into the left external iliac artery, followed by embolization of the main trunk of the right internal iliac artery and the installation of a femoro-femoral crossover bypass using an allograft. Angiographic control revealed no signs of endoleak in the endograft. At the 3-month follow-up CT angiography, the aneurysmal sac did not enhance, and the endograft showed no signs of endoleak.

Conclusions. Infrarenal abdominal aortic aneurysm with involvement of the unilateral iliac axis can be successfully resolved using a hybrid approach, involving coil embolization of the internal iliac artery trunk to prevent endoleak and femoro-femoral crossover bypass for the purpose of avoiding acute ischemia of the lower limb.