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Persistent Buttock Claudication after Endovascular Abdominal Aortic Aneurysm Repair

Alessandro Robaldo1, Stefano Pagliari1, Filippo Piaggio1

  • 1Vascular and Endovascular Surgery Unit, Imperia Hospital, Imperia, Italy.

Aorta (Stamford, Conn.)
|May 17, 2018
PubMed

Insights

A patient with disabling buttock claudication after internal iliac artery (IIA) embolization underwent successful open surgical repair. This highlights open surgery as a viable option for preserving pelvic inflow in high-risk patients.

Area of Science:

  • Vascular Surgery
  • Endovascular Interventions
  • Aortoiliac Disease

Background:

  • Endovascular aneurysm repair (EVAR) is common for aortoiliac aneurysms.
  • Internal iliac artery (IIA) embolization can cause buttock claudication.
  • Pelvic inflow preservation is crucial for preventing ischemic complications.

Observation:

  • A 71-year-old male experienced disabling right buttock claudication post-right IIA coil embolization.
  • CT angiography showed extensive aortoiliac calcifications and thrombus.
  • Symptoms persisted despite contralateral IIA patency and collateral flow.

Findings:

  • The patient underwent successful open infrarenal abdominal aortic aneurysm repair with stent-graft removal.
  • Concomitant revascularization of the right IIA was performed.
  • The patient remained asymptomatic at 30-month follow-up.

Implications:

  • Open surgery can be a successful solution for buttock claudication after IIA embolization.
  • Preserving pelvic inflow is vital, especially in high-risk patients with complex atheroma.
  • Consideration of open repair is important for managing complications of EVAR adjuncts.

Keywords:
Buttock claudicationCoil embolizationEndovascular abdominal aortic aneurysm repairInternal iliac artery

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