Endovascular Repair of an Internal Iliac Artery Aneurysm with Use of a Stented Graft and Embolization Coils

O SCVIR, 1995 T H E high mortality associated with ruptured internal iliac artery aneurysms dictates early prophylactic repair. The traditional therapeutic options include surgical excision, ligation, or obliterative endoaneurysmorrhaphy (1-5). Although the origin of the aneurysm may be easily oversewn, the anterior and posterior divisions of the internal iliac artery usually arise deep in the pelvis and may be difficult or impossible to ligate or oversew from within. Without occlusion of these vessels, the aneurysm can remain patent by filling from contralateral pelvic collaterals and the potential for aneurysm rupture remains. Percutaneous repair of an internal iliac artery aneurysm has been performed, but i t has required complete iliac occlusion and extraanatomic bypass, as described by Hollis et a1 (6). This report describes a transfemoral endovascular approach that is effective in excluding internal iliac artery aneurysms and maintaining circulation through the ipsilateral external iliac artery.