Endovascular Aneurysm Repair: Tortuous Iliac Artery Case Report
- Infrarenal abdominal aortic aneurysms (AAAs) - bulges in the aorta below the renal arteries - frequently enough require intervention to prevent rupture.
- A patient presented with an infrarenal AAA adn a markedly tortuous left common iliac artery.
- The procedure involved careful pre-operative planning with detailed imaging to map the anatomy.
Successful Endovascular Repair of Complex Abdominal Aortic Aneurysm
Table of Contents
published October 8, 2025
Understanding teh Challenge
Infrarenal abdominal aortic aneurysms (AAAs) – bulges in the aorta below the renal arteries – frequently enough require intervention to prevent rupture. Though, treating these aneurysms becomes considerably more complex when accompanied by severe tortuosity, or twisting, of the iliac arteries, the major blood vessels supplying the legs. This case report details a successful endovascular repair of an AAA intricate by extreme curvature in the left common iliac artery.
The Case: Severe Iliac Tortuosity
A patient presented with an infrarenal AAA adn a markedly tortuous left common iliac artery. Customary surgical repair posed substantial risks due to the difficult anatomy. Endovascular aneurysm repair (EVAR), a minimally invasive procedure using stent-grafts inserted through the femoral arteries, was considered the optimal approach, but even this presented challenges due to the severe angulation.
Endovascular Approach and Technique
The procedure involved careful pre-operative planning with detailed imaging to map the anatomy. A customized stent-graft was selected and deployed to exclude the aneurysm from blood flow. Navigating the tortuous iliac artery required specialized techniques and equipment to ensure accurate placement of the graft and maintain adequate blood flow to the leg. The team successfully navigated the challenging anatomy and achieved complete aneurysm exclusion.
Positive outcomes and Service Value
Post-operative assessments confirmed successful aneurysm exclusion with no immediate complications. The patient experienced a faster recovery and reduced post-operative pain compared to what would be expected with open surgical repair. This case highlights the value of advanced endovascular techniques in managing complex aortic pathology, offering patients a less invasive and perhaps safer treatment option. The ability to address such challenging anatomy demonstrates a commitment to providing cutting-edge vascular care and improving patient outcomes.