Endovascular management of aortoiliac artery occlusive disease with pseudo-stenosis of the external iliac artery

TL;DR

A case is described where endovascular treatment was used for aortoiliac artery disease with unusual external iliac artery narrowing.

Contribution

The paper highlights a rare case of pseudo-stenosis in the external iliac artery during endovascular treatment.

Findings

Pseudo-stenosis in the external iliac artery was confirmed without calcification or atheroma.

Balloon dilation was needed to recover EIA diameter after stent graft placement.

Careful stent graft sizing is necessary to avoid diameter mismatch in similar cases.

Abstract

In recent years, endovascular treatment has become the first-line revascularisation method for aortoiliac artery occlusive disease. Rarely, aortoiliac artery occlusive disease may be associated with stenosis of the external iliac artery (EIA) that suggested pseudo-stenosis. We describe a case of aortoiliac artery occlusive disease with EIA stenosis without calcification or atheroma. Stent grafts were inserted from the abdominal aorta to the bilateral common iliac arteries. Pre-operative computed tomography and intravascular ultrasound findings confirmed the absence of calcification or atheroma in both EIA, suggesting that the EIA had developed pseudo-stenosis. Following endovascular treatment, the EIA diameter recovered only with balloon dilation after inflow improvement. Consideration is necessary when placing an easy stent graft in the narrow EIA during endovascular treatment for aortoiliac artery occlusive disease with EIA stenosis to avoid a potential stent graft diameter mismatch.

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