Sequential coil embolization of bilateral internal iliac artery aneurysms prior to endovascular abdominal aortic aneurysm repair

Purpose: To report the endovascular repair of concomitant aneurysms of the abdominal aorta and both internal iliac arteries. Case Report: A 72-year-old man with a 5.5-cm abdominal aortic aneurysm (AAA ) extending to the right common iliac artery also presented with separate a neurysms of both internal iliac arteries. The patient refused conventional surgery, so an endovascular strategy was devised. Initially, the iliac aneu rysms were sequentially coil embolized, allowing several weeks to elapse be tween the embolization sessions to encourage collateral development. A bifu rcated Talent endograft was inserted successfully 8 months after the initia l intervention; no evidence of endoleaks or mesenteric ischemia has been se en over a 1-year followup. Conclusions: This case illustrates the feasibility of inducing collateraliz ation prior to endovascular AAA repair that would jeopardize internal iliac artery circulation bilaterally Sequential embolization of the internal ili ac arteries over several months initiates this response, paving the way for eventual endovascular repair of the primary aortic aneurysm.