Successful endovascular treatment of a ruptured internal iliac aneurysm

Internal iliac artery aneurysms (IIAs) are rare but can be the source of considerable morbidity when rupture occurs. IIAs have traditionally been treated with direct surgical exclusion or ligation. More recently, the advent of endovascular techniques have been adapted to treat isolated common and IIAs in lieu of elective surgical correction. This case report describes an 81-year-old patient with multiple medical problems and a symptomatic IIA, initially diagnosed with computed tomographic scan. Arteriography results showed extravasation of contrast from a left IIA. The aneurysm was treated with endovascular exclusion, with multiple coils in the IIA followed by placement of a covered stent within the common and external iliacs to exclude the orifice of the IIA. The patient tolerated the procedure well, and at 2 months after the procedure, no endoleak was present on follow-up computed tomographic scan results. At 12 months postprocedure, the patient has remained well. This case shows that endovascular therapies may offer a good treatment option in symptomatic or ruptured IIA, particularly in a patient who is at poor operative risk.