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Colonic ischemia after endovascular exclusion of an aortoiliac aneurysm using an iliac branch device

Giorgos S Sfyroeras1, Stylianos Koutsias, Christos Karathanos

  • 1Department of Vascular Surgery, University of Thessaly Medical School, Larissa, Greece. gsfyr@yahoo.gr

Vascular and Endovascular Surgery
|May 21, 2010
PubMed

Insights

This case study highlights colonic ischemia (CI) following endovascular aneurysm repair with an iliac branch device (IBD). Adequate collateral circulation is crucial, especially when the inferior mesenteric artery (IMA) is excluded.

Area of Science:

  • Vascular Surgery
  • Gastrointestinal Surgery

Background:

  • Endovascular aneurysm repair (EVAR) using iliac branch devices (IBD) is a common treatment for aortoiliac aneurysms.
  • Preservation of bilateral iliac artery patency is generally aimed to prevent pelvic ischemia.

Observation:

  • A 69-year-old male patient with an aortoiliac aneurysm underwent EVAR with an IBD.
  • Postoperatively, the patient developed moderate colonic ischemia (CI) despite patent iliac arteries and a patent inferior mesenteric artery (IMA).

Findings:

  • The patient was treated conservatively for CI and discharged after 15 days with symptom resolution.
  • This case suggests that even with patent IMA, exclusion during EVAR can compromise left colon blood supply.

Implications:

  • Exclusion of the inferior mesenteric artery (IMA) during endovascular exclusion of aortoiliac aneurysms may lead to colonic ischemia (CI).
  • Careful consideration of collateral circulation is essential to prevent CI in patients undergoing EVAR with IBD, particularly when the IMA is involved.
Abstract

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