Werner-Gibbings Keagan, Rogan Chris, Robinson David
Department of Vascular Surgery, Royal Prince Alfred Hospital, Missenden Road, Sydney, NSW 2050, Australia.
Case Rep Vasc Med. 2013;2013:861624. doi: 10.1155/2013/861624. Epub 2013 Jun 13.
Internal iliac artery (IIA) aneurysms, while rare, carry a significant risk of mortality if they rupture. Endovascular intervention is now the preferred method of treatment for IIAs; however, due to technical considerations, this is not always feasible. We report a case of a patient who developed an enlarging IIA aneurysm in association with a type 2 endoleak supplied by multiple feeding arteries where conventional endovascular treatment was not possible. A novel method of effectively treating the IIA aneurysm with a posterior approach via image-guided puncture of the superior gluteal artery was employed. Five arteries supplying the superior gluteal from the contralateral internal iliac artery were selectively catheterised and coiled before the aneurysmal sac was embolised. The patient made an uneventful recovery, and follow-up imaging demonstrated resolution of the endoleak and decompression of the aneurysmal sac. This case demonstrates that the posterior approach is a safe and viable method of treating internal iliac artery aneurysm when traditional endovascular approaches are technically possible.
髂内动脉（IIA）动脉瘤虽然罕见，但一旦破裂会带来显著的死亡风险。血管内介入治疗目前是IIA动脉瘤的首选治疗方法；然而，由于技术方面的考虑，这种方法并非总是可行。我们报告一例患者，其IIA动脉瘤不断增大，并伴有由多条供血动脉供血的2型内漏，传统血管内治疗无法实施。采用了一种通过影像引导穿刺臀上动脉的后路方法有效治疗IIA动脉瘤的新方法。在栓塞动脉瘤囊之前，对来自对侧髂内动脉的五条供应臀上动脉的血管进行了选择性插管和弹簧圈栓塞。患者恢复顺利，随访影像显示内漏消失，动脉瘤囊减压。该病例表明，当传统血管内治疗在技术上不可行时，后路方法是治疗髂内动脉动脉瘤的一种安全可行的方法。
