Abstract

Case Report

Limb ischemia after coil migration used for a hypogastric aneurysm embolization

Miquel Gil Olaria*, Natalia Hernandez Wiesendange, Clàudia Riera Hernández, Carlos Esteban Gracia and Secundino Llagostera Pujol

Published: 10 February, 2021 | Volume 5 - Issue 1 | Pages: 004-006

Hypogastric artery aneurysms are an uncommon entity. When the diameter achieves > 30-35 mm, they should be treated. Endovascular repair may be considered as first line therapy. One therapeutic option for internal iliac artery aneurysm exclusion is its embolization with or without covering the ostium with a covered stent. They may be some complications when it is not, as a distal coil migration that may produce ischemic symptoms.

We are presenting a 73-years-old male admitted to hospital with an acute right lower limb ischemia caused by a coil migration. He recently underwent a right hypogastric artery aneurysm endovascular treatment by coil embolization without covering the hypogastric ostium with a covered stent. The patient underwent an emergency surgery to remove the coil by a transfemoral surgical approach with posterior thrombectomy of the secondary thrombus. Actually, he remains asymptomatic and with right posterior tibial pulse.

Covered stent placement at the common iliac artery and external iliac artery could be the best option to avoid the risk of aneurysm rupture caused by endotension and the risk of distal coil migration.

Read Full Article HTML DOI: 10.29328/journal.acr.1001045 Cite this Article Read Full Article PDF

Keywords:

Iliac Aneurysm; Embolization, Therapeutic; Lower extremity; Ichemia

References

  1. Brunkwall J, Hauksson H, Bengtsson H, Bergqvist D, Takolander R, et al. Solitary aneurysms of the iliac arterial system: An estimate of their frequency of occurrence. J Vasc Surg. 1989; 10: 381-384. PubMed: https://pubmed.ncbi.nlm.nih.gov/2795762/
  2. Rana MA, Kalra M, Oderich GS, de Grandis E, Gloviczki P, et al. Outcomes of open and endovascular repair for ruptured and nonruptured internal iliac artery aneurysms. J Vasc Surg. 2014; 59: 634-644. PubMed: https://pubmed.ncbi.nlm.nih.gov/24571938/
  3. Forsdahl SH, Singh K, Solberg S, Jacobsen BK. Risk factors for abdominal aortic aneurysms: a 7-year prospective study: the Tromsø Study, 1994-2001. Circulation. 2009; 119: 2202-2208. PubMed: https://pubmed.ncbi.nlm.nih.gov/19364978/
  4. Wilhelm BJ, Sakharpe A, Ibrahim G, Baccaro LM, Fisher J. The 100-Year Evolution of the Isolated Internal Iliac Artery Aneurysm. Ann Vasc Surg. 2014; 28: 1070-1077. PubMed: https://pubmed.ncbi.nlm.nih.gov/24333603/
  5. Brin BJ, Busuttil RW. Isolated Hypogastric Artery Aneurysms. Arch Surg. 1982;117: 1329. PubMed: https://pubmed.ncbi.nlm.nih.gov/6896988/
  6. McCready RA, Pairolero PC, Gilmore JC, Kazmier FJ, Cherry KJ, et al. Isolated iliac artery aneurysms. Surgery. 1983; 93: 688-693. PubMed: http://www.ncbi.nlm.nih.gov/pubmed/6845175
  7. Wanhainen A, Verzini F, Van Herzeele I, Allaire E, Bown M, et al. European Society for Vascular Surgery (ESVS) 2019 Clinical Practice Guidelines on the Management of Abdominal Aorto-iliac Artery Aneurysms. Eur J Vasc Endovasc Surg. 2019; 57: 8-93. PubMed: https://pubmed.ncbi.nlm.nih.gov/30528142/
  8. Ballesteros-Pomar M. Aneurismas de arteria iliaca: Actualización y algoritmos de decisión. Angiologia. 2017; 69: 291-298.
  9. Kliewer M, Plimon M, Taher F, Walter C, Hirsch K, et al. Endovascular treatment of hypogastric artery aneurysms. J Vasc Surg. 2019; 70: 1107-1114. PubMed: https://pubmed.ncbi.nlm.nih.gov/31147136/
  10. Malgor RD, Oderich G. Diagnosing and managing internal iliac artery aneurysms. 2015.

Figures:

Figure 1

Figure 1

Figure 1

Figure 2

Similar Articles

Recently Viewed

Read More

Most Viewed

Read More