Percutaneous transgluteal coil embolization of bilateral internal iliac artery aneurysms via direct superior gluteal artery access

Proximal surgical ligation of internal iliac artery aneurysms without occlusion of the outflow vessels can lead to continued aneurysm expansion and possible rupture from retrograde flow. Percutaneous embolization options are limited because there is no direct transarterial antegrade access to the aneurysm if the internal iliac artery has been ligated. We describe the first case of bilateral percutaneous transgluteal coil embolizations to treat surgically excluded bilateral internal iliac artery aneurysms.