Endovascular Repair of an Iliac Artery Pseudoaneurysm Using a Surgeon-Reconstructed Prosthetic Graft and a Bare Metal Stent

Iliac artery aneurysms are usually asymptomatic. Herein, we report a novel strategy for the repair of a pseudoaneurysm involving the external iliac artery using a conventional artificial graft and bare metal stent. A 76-year-old male patient presented with severe resting pain and right foot discoloration. Computed tomography angiography revealed a right distal external iliac artery pseudoaneurysm, with severe calcified occlusion at the right common and superficial femoral arteries. After exposing the right femoral artery, long-segment endarterectomy and patch angioplasty with the ipsilateral greater saphenous vein were performed. Before the completion of patch angioplasty, a surgeon-modified 8-mm expanded polytetrafluoroethylene (ePTFE) graft was inserted for complete pseudoaneurysm repair. If a commercial covered stent is not available, minimally invasive endovascular repair can be safely performed using a surgeon-modified ePTFE graft and bare metal stent.