Unsuccessful embolisation of a right internal iliacartery aneurysm using an Amplatzer plug in two cases—Learning points

Abstract

Amplatzer vascular plugs (AVP) are increasingly being used in the treatment of peripheral vascular aneurysms. We present two cases of unsuccessful percutaneous endovascular embolizations of right internal iliac artery (IIA) aneurysms using AVPs at the origin of the aneurysm. The first patient presented with partial rupture of a right IIA aneurysm 3 weeks after embolization, with the AVP seen free within the lumen of the aneurysm. Final occlusion was successfully achieved with a second AVP, thrombin and coil embolization. The second patient had treatment with an AVP for an incidental right IIA aneurysm on computer tomography angiography (CTA) following a previous surgical aorto-biiliac graft. Post-embolization CTA demonstrated a proximal leak via the AVP. This was successfully occluded with a right common iliac stent graft.