Preservation of pelvic perfusion in endovascular aneurysm repair

Endovascular aneurysm repair requires a suitable anatomy for placement of covered stent grafts, which includes a non-aneurysmal distal landing zone within the common iliac arteries. Patients with iliac artery aneurysms, thus, are often not candidates for this minimally invasive repair, as extension of the graft to an appropriate site would cover the internal iliac artery and result in significant symptoms related to poor pelvic perfusion. We present two cases of common iliac artery aneurysms treated by modified endovascular techniques with good results. Select patients with iliac artery aneurysms may be candidates for endovascular repair. These patients should be referred to centers familiar with these techniques.