Preceding Coil Embolization for Internal Iliac Artery Aneurysm before Open Repair

• Published in: Indian journal of vascular and endovascular surgery Vol. 3; no. 3; pp. 78 - 82
• Main Authors: Morisaki, Akimasa, Hosono, Mitsuharu, Sakaguchi, Masanori, Shibata, Toshihiko
• Format: Journal Article
• Language: English
• Published: Medknow Publications and Media Pvt. Ltd 01.07.2016; Wolters Kluwer Medknow Publications
• Subjects: Aneurysm; Care and treatment; Coil embolization; internal iliac artery aneurysm; Methods; open repair; Patient outcomes; Therapeutic embolization
• ISSN: 0972-0820; 2394-0999
• DOI: 10.4103/0972-0820.186717

Introduction: In the era of endovascular repair, open repair for abdominal aortic aneurysm (AAA) is still needed in the patients who had anatomical difficulties with the endovascular repair. Open repair for internal iliac artery aneurysm (IIAA) is a challenge because of the deep operating field, which is associated with high morbidity. Therefore, we performed preceding coil embolization for IIAA before open repair to control the bleeding from gluteal arteries. Materials and Methods: The present study is a retrospective case series study. Ten patients underwent preceding coil embolization for IIAA before open repair between January 2010 and August 2015. Three patients had two-stage coil embolization for bilateral IIAA. Six patients also had infrarenal AAAs. After preceding coil embolization, open repair consisting of vascular graft replacement with aneurysmectomy and closure of IIAA was undertaken. Results: The mean age was 72.5 ± 10.7 years. There were nine men and one woman. Operative time and intraoperative bleeding were 270 ± 50 min and 817 ± 671 mL, respectively. There was no postoperative mortality. Three patients developed morbidity, which consisted of paralytic ileus, pneumonia, and shower embolization caused by shaggy aorta. No recurrent IIAA, buttock claudication, and intestinal ischemia after the open repair were observed. Conclusion: Preceding coil embolization for IIAA before open repair may be an effective procedure to control the bleeding from gluteal arteries and prevent recurrent IIAA.