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

Authors

  • Sorin Barat ”Timofei Moșneaga” Republican Clinical Hospital, Chișinău, Republic of Moldova
  • Aurel Turcan “Nicolae Testemiţanu” State University of Medicine and Pharmacy, Chișinău, Republic of Moldova
  • Stefan Manica ”Timofei Moșneaga” Republican Clinical Hospital, Chișinău, Republic of Moldova
  • Maxim Tran “Nicolae Testemiţanu” State University of Medicine and Pharmacy, Chișinău, Republic of Moldova

DOI:

https://doi.org/10.5281/zenodo.10429498

Keywords:

EVAR, crossover bypass, aneurysm

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.

Published

24-12-2023

Issue

Section

CLINICAL CASES