Stent graft placement for internal iliac artery aneurysm after recanalization of the occluded celiacomesenteric trunk: a case report

TL;DR

A two-stage endovascular approach successfully treated a complex arterial aneurysm and prevented organ ischemia in a 74-year-old patient.

Contribution

Demonstrates a novel two-stage endovascular strategy for treating aneurysms in patients with occluded arteries.

Findings

Recanalization of the occluded celiacomesenteric trunk prevented ischemia.

Stent graft placement in the iliac artery showed no complications after one year.

Collateral vessel diameter decreased following successful intervention.

Abstract

A 74-year-old male patient with a right internal iliac artery aneurysm had an occluded celiacomesenteric trunk with collateral blood flow via the dilated right middle rectal, superior rectal, and left colic arteries. To prevent hepatic and gastrointestinal ischemia after stent graft placement, the celiacomesenteric trunk was recanalized using angioplasty and stenting. One month later, CT confirmed stent patency and reduced collateral vessel diameter. Two months after recanalization, the right internal iliac artery branches were embolized, and a stent graft was placed from the common to the external iliac artery. One year after the procedure, the patient showed no signs of ischemia, aneurysm enlargement, or endoleaks. In conclusion, a two-stage endovascular approach appears to be effective in preventing ischemic complications while addressing the aneurysm.

Level of evidence Level 4, Case Report.

Figures