CT-fusion-guided endovascular repair of iatrogenic common iliac artery aneurysm: A case report

We present a case of a CT-fusion-guided endovascular repair of an iatrogenic common iliac artery aneurysm in a 60-year-old male with a history of robotic prostatectomy with wide lymphadenectomy. Taking into account iatrogenic nature, rapid evolvement, previous surgical intervention, and oncological history, our team, including vascular and endovascular surgeons, refused open surgery in favor of endovascular iliac repair. We coiled the ipsilateral hypogastric artery and then deployed 2 Fluency Plus stent grafts from the common iliac into the external iliac artery. All manipulations were made under CT-fusion vascular mask control, which provided precise neck positioning, a minimal contrast infusion, reduced radiation dose, and better overall control. Our results suggest that anatomically suitable isolated iliac aneurysms can be successfully and safely treated with CT-fusion-guided endovascular repair without major perioperative and mid-term complications. The case is highlighting the potential complexity of repeated surgery with previously operated patients and the necessity of surgical and endovascular team interactions, especially in case of iatrogenic vascular complications.