A Giant Left Common Iliac Artery Aneurysm with Endovascular Repair: A Case Report

Common iliac artery aneurysm (CIAA) is a very rare entity, but with potentially disastrous evolution, aneurysm rupture or distal embolization. A specific management, surgical or endovascular procedure, is required. We present a case with a huge distal left common iliac artery aneurysm, in which the diagnosis was made incidentally during a weekly ultrasound examination, in spite of impressive dimensions, 9 cm diameter. The patient was then examined by 128- Slices computed tomography and angio-coronarography. Despite the attractive anatomy for direct surgery with resection of the aneurysm and restoration of the iliac tract through the interposition of a tubular prosthesis, due to the previous pathology of the patient with necrotizing fasciitis in the left lower limb and abdominal wall, endovascular intervention was decided. Because, the big size of the left common iliac artery aneurysm, located distally, with tortuosity of the left common iliac artery as well external iliac artery (EIA), permeable left internal iliac artery (IIA), extensive intra-aneurysmal thrombosis, endovascular procedure was complex and particular. The peculiarities of the case and the complex endovascular technique, with the placement of a stent graft on the infrarenal abdominal aorta, extended on both common iliac arteries, embolization of the left internal iliac artery and extension of the left arm on the external iliac artery, are described in this presentation.