Manaki Vasiliki, Bontinis Vangelis, Bontinis Alkis, Giannopoulos Argirios, Kontes Ioannis, Kitromilis Andreas, Ktenidis Kiriakos
Department of Vascular Surgery, "AHEPA" University Hospital of Thessaloniki, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Vasc Specialist Int. 2024 Dec 30;40:44. doi: 10.5758/vsi.240089.
Isolated iliac aneurysms are rare, and their management becomes complex when accompanied by ectopic pelvic kidneys due to altered vascular anatomy. We report a 58-year-old male with an incidentally discovered 53.5 mm left common iliac artery (CIA) aneurysm and an ectopic pelvic kidney. The main renal artery originated from the left proximal CIA, with two smaller polar arteries arising from the left internal iliac artery (IIA). The aneurysm was treated endovascularly with two Gore Excluder iliac limbs and coil embolization of the IIA, successfully excluding the aneurysm while preserving renal circulation. Postoperative creatinine levels remained stable, and follow-up imaging showed no complications. This case highlights the challenges of treating iliac aneurysms in patients with ectopic kidneys, where renal perfusion and adequate sealing are crucial. Endovascular techniques, including stent grafts and IIA embolization, offer safe and effective options for such complex cases.
孤立性髂动脉瘤较为罕见，当伴有异位盆腔肾时，由于血管解剖结构改变，其治疗变得复杂。我们报告一例58岁男性，偶然发现左侧髂总动脉（CIA）有53.5 mm的动脉瘤以及一个异位盆腔肾。主要肾动脉起源于左侧近端CIA，两条较小的极动脉起源于左髂内动脉（IIA）。该动脉瘤通过使用两个戈尔覆膜支架髂支进行血管内治疗，并对IIA进行弹簧圈栓塞，成功排除动脉瘤，同时保留了肾循环。术后肌酐水平保持稳定，随访影像学检查未发现并发症。该病例突出了异位肾患者髂动脉瘤治疗的挑战，其中肾灌注和充分封堵至关重要。血管内技术，包括支架移植物和IIA栓塞，为这类复杂病例提供了安全有效的选择。
