CT-guided embolization of an isolated internal iliac artery aneurysm 8 years after AAA repair

Purpose: To report the use of computed tomographic (CT) guidance for percutaneous treatment of an isolated internal iliac artery (IIA) aneurysm after open aortic aneurysm repair. Case Report., A 74-year-old man presented with an isolated IIA aneurysm 8 years after an open repair of his abdominal aortic aneurysm. In view of his diabetes, hypertension, and chronic renal impairment, an endovascular technique was selected. However, because of previous ligation of the internal iliac origin, a transarterial approach could not be used. The proximity of the aneurysm to the anterior abdominal wall allowed us to gain access to it percutaneously using CT guidance to perform embolization. Conclusion: CT-guided direct puncture of isolated IIA aneurysms adds to the current armamentarium of minimally invasive modalities. It is a technique that can be applied to isolated IIA aneurysms that develop subsequent to AAA repair or appear in cases where intra-arterial access is not possible.