Department of Vascular Surgery, S. Anna University Hospital of Ferrara and University of Ferrara, Ferrara, Italy.
Vascular. 2024 Jun;32(3):550-553. doi: 10.1177/17085381231155939. Epub 2023 Feb 3.
Isolated aneurysms of the internal iliac arteries (IIIAA) are a rare variant of aorto-iliac aneurysms, representing only 0.3-0.5% of intra-abdominal aneurysms. Bilateral isolated hypogastric artery aneurysms are even more rare. The rarity of IIIAA has determined the absence of a high level of evidence about its treatment.
We present a case of bilateral isolated internal iliac artery aneurysms treated in two stages by positioning GORE VIABAHN VBX Balloon Expandable Endoprosthesis large, chosen for the possibility to adapt it to the anatomical diameter variations between the hypogastric artery and the posterior trunk, which was the distal landing zone chosen in both sides.
Total patency was detected 1 year after surgery in both sides. No buttock claudication, erectile dysfunction and/or signs of bowel ischaemia were referred. Preserving the hypogastric flow is an important goal in isolated hypogastric arteries aneurysms' treatment and covered stenting surely represents a valid therapeutical choice.
孤立性髂内动脉瘤(IIIAA)是一种罕见的腹主动脉-髂动脉瘤变异,仅占腹主动脉瘤的 0.3-0.5%。双侧孤立性髂内动脉动脉瘤更为罕见。IIIAA 的罕见性决定了其治疗缺乏高水平的证据。
我们报告了一例双侧孤立性髂内动脉动脉瘤的病例,采用定位戈尔 VIABAHN VBX 球囊扩张式血管内支架进行两阶段治疗,选择这种支架是因为它有可能适应髂内动脉和后干之间的解剖学直径变化,这是双侧选择的远端着陆区。
手术后 1 年双侧均检测到完全通畅。没有出现臀部跛行、勃起功能障碍和/或肠道缺血迹象。保留髂内动脉血流是治疗孤立性髂内动脉动脉瘤的一个重要目标,覆膜支架肯定是一种有效的治疗选择。