A new technique for embolisation of the hypogastric artery

Summary

Introduction

Embolisation of hypogastric arteries prior to the placement of aortoiliac stents to treat aneurysms is not always possible.

Aim

To present a new technique for the embolisation of ‘hostile’ hypogastric arteries which is performed at the same time as the placement of the aortoiliac stent.

Patients and methods

This procedure was used to treat six patients with aortoiliac (4) and iliac (2) aneurysms. Follow-up was carried out by computerised tomography (CT) in the first week and at one, three and six months. Endovascular technique: a) Placement of a coudé catheter near the hypogastric artery or in the sac; the stent is introduced through the same arteriotomy; b) The stent is deployed and, before ballooning it, the coils are released; c) 100 to 200 cm³ of serum are injected into the sac to wash the coils towards the ostium of the hypogastric artery; d) Withdrawal of the catheter and ballooning of the distal end of the stent.

Results

The CT scan showed thrombosis of the iliac aneurysm in the first week in four of the patients and at one month in the others. There were no signs of endoleaks or movements of the coils inside the sac. Buttock claudication was noted in four of the six patients. There were no cases of colic ischaemia.

Conclusions

This original method of embolisation has proved to be effective and safe with regard to its capacity to thrombose arteries that are potential producers of type II endoleaks, since it prevents unwanted movements of the coils.