Cross-pelvic retrograde embolization of an enlarging proximally occluded internal iliac artery aneurysm: A case report

Abstract

Internal iliac artery aneurysms are frequently treated by embolization and stent graft coverage, however, retrograde flow from pelvic collaterals may lead to aneurysm progression that can be difficult to treat. We present the case of a 76-year-old male with an enlarging internal iliac artery aneurysm despite occlusion of the proximal internal iliac artery and no antegrade filling of the aneurysm sac. Through cross-pelvic retrograde access of the aneurysm sac via collaterals, we used a triaxial telescoping system for embolization of the aneurysm nidus, without major morbidity. This technique is a safe and effective option that can be used in cases where antegrade access is not feasible.