2024 Volume 44 Issue 1 Pages 47-50
The patient was a 72-year-old man who was brought to our hospital with impaired consciousness and in a shock state. Contrast-enhanced CT showed a saccular aneurysm in the left common iliac artery measuring 43 mm in diameter and perforating the IVC. Emergency endovascular aortic repair (EVAR) was performed. Angiography also showed leakage of contrast material from the left common iliac artery aneurysm into the IVC. After insertion of the stent graft, the blood pressure rose promptly. Angiography after insertion of the stent and postoperative follow-up contrast-enhanced CT no longer showed any obvious endoleak, and the arteriovenous fistula could no longer be visualized. The patient was discharged on day 8 after the procedure. Perforation of the IVC by an iliac artery aneurysm is a rare, but potentially fatal condition that requires prompt treatment. Since the symptoms are nonspecific, imaging is important, and EVAR is a promising treatment option, as it results in rapid circulatory recovery.
