Hypogastric artery aneurysms (HAA) necessitate repair due to significant morbidity and potential mortality associated with rupture. Coverage or coiling of HAA are not always possible, as the risk of pelvic and spinal cord ischemia become especially significant in bilateral hypogastric disease as well as with prior extensive aortic coverage. We report 2 cases of endovascular HAA exclusion using parallel stent grafts for preservation of flow through the distal hypogastric artery branches and external iliac artery in patients with prior thoracic and abdominal aortic repairs, contralateral hypogastric disease, and significant anatomic constraints.
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MatteoJCunninghamJ. Size matters! A reliable endovascular method to avoid infolding and endoleaks when reconstructing aortic bifurcations using stent grafts. Vascular. 2012;20(3):124–128.
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FarahmandPBecqueminJPDesgrangesPAllaireEMarzelleJRoudot-ThoravalF. Is hypogastric artery embolization during endovascular aortoiliac aneurysm repair (EVAR) innocuous and useful?Eur J Vasc Endovasc Surg. 2008;35(4):429–435.
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KarchLAHodgsonKJMattosMABohannonWTRamseyDEMcLaffertyRB. Adverse consequences of internal iliac artery occlusion during endovascular repair of abdominal aortic aneurysms. J Vasc Surg. 2000;32(4):676–683.
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YanoOJMorrisseyNEisenL. Intentional internal iliac artery occlusion to facilitate endovascular repair of aortoiliac aneurysms. J Vasc Surg. 2001;34(2):204–211.
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RaytHSBownMJLambertKV. Buttock claudication and erectile dysfunction after internal iliac artery embolization in patients prior to endovascular aortic aneurysm repair. Cardiovasc Intervent Radiol. 2008;31(4):728–734.
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MehtaMVeithFJOhkiT. Unilateral and bilateral hypogastric artery interruption during aortoiliac aneurysm repair in 154 patients: a relatively innocuous procedure. J Vasc Surg. 2001;33(suppl 2):S27–S32.
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KotsisTTsanisASfyroerasGLioupisCMoulakakisKGeorgakisP. Endovascular exclusion of symptomatic bilateral common iliac artery aneurysms with preservation of an aneurysmal internal iliac artery via a reverse-U stent-graft. J Endovasc Ther. 2006;13(2):158–163.
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BekdacheKDietzekAMChaANeychevV. Endovascular hypogastric artery preservation during endovascular aneurysm repair: a review of current techniques and devices. Ann Vasc Surg. 2015;29(2):367–376.
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LobatoACCamacho-LobatoL. The sandwich technique to treat complex aortoiliac or isolated iliac aneurysms: results of midterm follow-up. J Vasc Surg. 2013;57(suppl 2):26S–34S.
