Aorto-internal iliac artery endovascular reconstruction for critical limb ischaemia: a case report

Area of Science:

• Vascular Surgery
• Interventional Cardiology
• Endovascular Therapy

Background:

• Severe aortoiliac occlusive disease presents a significant challenge in vascular surgery.
• The internal iliac artery and cruciate anastomosis serve as critical collateral pathways.
• Occlusion of iliac arteries can lead to critical limb ischemia and rest pain.

Observation:

• A patient presented with left leg rest pain due to occlusion of the left common and external iliac arteries.
• High-grade stenosis was also noted in the right common iliac artery.
• The left internal iliac artery was found to be patent via direct catheter cannulation.

Findings:

• Successful endovascular stent placement re-established blood flow through the left internal iliac artery.
• The patient's ischemic rest pain was relieved post-procedure.
• Ankle-brachial index was maintained at 0.85 at 6 months follow-up, indicating sustained improvement.

Implications:

• This case highlights the potential of endovascular stenting for managing complex aortoiliac occlusive disease.
• Preserving or restoring flow through the internal iliac artery can be crucial for limb salvage.
• Endovascular techniques offer a viable alternative for patients with severe aortoiliac disease affecting collateral circulation.