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      Aneurisma gigante de arteria iliaca interna roto Translated title: Giant ruptured internal iliac aneurysm

      case-report

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          Abstract

          Objetivo: Presentar un caso infrecuente de aneurisma gigante de arteria iliaca interna roto. Caso clínico: Varón de 68 años de edad con antecedentes de hipertensión arterial crónica, dislipidemia, cardiopatía valvular, cor pulmonale con hipertensión pulmonar moderada, portador de marcapasos definitivo, obesidad y alergia a la plata. Ingresa de urgencia por dolor brusco en fosa iliaca izquierda, irradiado periumbilicalmente sin cortejo vegetativo. En el TC abdominal se objetiva la presencia de un aneurisma gigante de la arteria hipogástrica izquierda con diámetro de 6,8 cm y signos de rotura. Se realiza de forma urgente cirugía endovascular mediante implante de prótesis Endurant® y embolización de arterias glúteas con Coils Interlock®. Control al mes y a los 6 meses sin endofugas ni crecimiento del saco. Discusión: El tratamiento de elección de los aneurismas iliacos sigue siendo la cirugía, de forma electiva cuando el diámetro de la arteria es mayor de 3 cm y urgente cuando debutan con rotura. La terapia endovascular es una alternativa segura y eficaz a la cirugía convencional, con resultados satisfactorios a corto y medio plazo.

          Translated abstract

          Aim: To present an infrequent broken giant Iliac artery aneurysms. Case report: In the current study, we report a case of a 68-year-old male patient with chronic high blood pressure, cholesterol, valvular heart disease, cor pulmonale, pacemaker, obesity and silver allergic. He presented sudden onset of abdominal pain. Computed tomography (CT) revealed a large ruptured left hypogastric aneurysm (diameter of 6.8 cm). Hypogastric aneurysm was repaired by an endovascular graft repair: Endurant® endogratf and coils embolization of gluteal arteries (Interlock®). The patient had a satisfactory clinical progression and recovery. At one and six months after the operation TC revealed not Type II endoleaks. Discussion: Isolated aneurysms of the iliac arteries are rare. Surgical treatment is recommended for iliac artery aneurysms larger than 3 cm. Endovascular repair is an attractive method to repair isolated iliac artery aneurysms with lower morbidity and mortality rates than open surgery.

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          State of the art: management of iliac artery aneurysmal disease.

          Although relatively uncommon, isolated iliac artery aneurysms are associated with significant risk of rupture and death. Clinical presentation can be confusing and ultrasound or CT imaging is paramount in establishing the diagnosis and anatomical extent of disease. Important considerations prior to intervention include determination of proximal neck, involvement of the internal iliac artery, and status of the contralateral internal iliac artery. Endovascular repair has evolved as the first choice treatment option for patients with anatomically suitable iliac artery aneurysms. In uncommon circumstances when endovascular treatment may result in significant pelvic ischemia or the primary symptoms are related to extrinsic compression of adjacent structures, surgical repair may be the preferred option.
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            Common iliac and hypogastric aneurysms: open and endovascular repair.

            Currently, there are a variety of open surgical, endovascular, and hybrid options to treat iliac artery aneurysms (IAA). Anatomy of the common iliac artery (CIA) with regard to proximal and distal neck, involvement of the iliac bifurcation, and choice to preserve the ipsilateral internal iliac artery (IIA) all play a role in the decision process towards the preferred treatment method. This manuscript describes the available open surgical and endovascular techniques for the treatment of IAA. Indications, advantages and limitations, and outcomes of each technique are discussed.
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              Ruptured solitary internal iliac artery aneurysm: a rare cause of large-bowel obstruction.

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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                rchcir
                Revista chilena de cirugía
                Rev Chil Cir
                Sociedad de Cirujanos de Chile
                0718-4026
                June 2016
                : 68
                : 3
                : 250-253
                Affiliations
                [1 ] Hospital Universitario Puerta del Mar España
                [2 ] UGC Medina Sidonia España
                Article
                S0718-40262016000300010
                10.1016/j.rchic.2015.10.001
                c73edd21-437b-4d42-bc7a-0ef07b6e6abd

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                Product

                SciELO Chile

                Self URI (journal page): http://www.scielo.cl/scielo.php?script=sci_serial&pid=0718-4026&lng=en
                Categories
                SURGERY

                Surgery
                Aneurysm,Hypogastric artery,Ruptured,Endovascular repair,Aneurisma,Arteria hipogástrica,Rotura,Tratamiento endovascular

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