Exclusión endovascular de un pseudoaneurisma ilíaco gigante sintomático

Summary. Introduction. Iliac artery pseudoaneurysms are uncommon. Their rupture is associated with high mortality rates. Prosthetic replacement is the treatment of choice, but endovascular techniques can be an alternative to surgical treatment. Case report. 76 year old male with chronic obstructive pulmonary disease and hypertensive heart disease who presented with a several month history of edema and pain at his left thigh. The physical examination revealed a pulsatile mass in the meso-hypogastric region and the left iliac fossa. An abdominal computerized tomography scan and an arteriography showed a left common iliac artery pseudoaneurysm with a maximum diameter of 16 cm and no evidence of rupture. The patient was scheduled for surgery under epidural anesthesia, which consisted in the implant of a right aortouni-iliac endoprosthesis with suprarenal attachment and an occluder in the left external iliac artery, together with a femorofemoral crossover bypass with complete exclusion of the aneurysm and no immediate complications. The patient was discharged 5 days after surgery. The 6-month and 1-year follow-up computerized tomography scans confirmed the thrombosis and exclusion of the pseudoaneurysm and the absence of symptoms in the left lower limb. Conclusion. Percutaneous exclusion of iliac artery pseudoaneurysms by means of the implant of endovascular stent grafts is a safe and effective technique associated with low morbidity and mortality rates in selected patients. [ANGIOLOGÍA 2008; 60: 43-8]