PMC7115704_01
a. Preoperative CT image with three-dimensional reconstruction showing isolated saccular-type, right common iliac artery aneurysm. b. Preoperative axial CT image at the level of black arrow shows relatively narrow abdominal aorta (24.0 x 22.5 cm) approximately 2.5 cm above the level of the terminal aorta. c. Preoperative axial CT image at the level of the black arrow head shows relatively narrow terminal aorta (24.2 x 20.7 cm). CT, computed tomography.
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While investigating for pancreatitis, computed tomographic angiography incidentally revealed an isolated saccular-type, right CIA aneurysm with a maximum diameter of 35 mm (Fig. 1a). The patient's terminal aorta (24 mm) was marginal to apply this device (Fig. 1b and c).
a. Postoperative CT image with three-dimensional reconstruction showing a marked compression of the contralateral leg by the bridging device in the terminal aorta, which is visible only in the left anterior oblique view. b. Postoperative axial CT image at the level of the black arrow shows a marked compression of the contralateral leg in the terminal aorta. c. Postangioplasty axial CT image shows the alleviated compression. CT, computed tomography.
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However, his routine postoperative computed tomographic angiography revealed a marked compression of the contralateral leg by the bridging device in the terminal aorta, which was visible only in the left anterior oblique (LAO) view (Fig. 2a). Its axial image seemed similar to a subtotal occlusion (Fig. 2b). Tempe, USA) was implanted using balloon angioplasty with improvement (Video 3). Plain computed tomography revealed alleviation of the subtotal occlusion (Fig. 2c).
CT images with three-dimensional reconstruction 1 year after endovascular aortic repair. a. Anteroposterior view shows a patent right internal iliac artery without leakage. b. Left anterior oblique view shows the alleviated compression of the contralateral leg in the terminal aorta. CT, computed tomography.
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The patient was discharged and has remained asymptomatic during the 1-year follow-up at our clinic. The computed tomographic angiography at 1 year showed successfully patent left leg without any leakage (Fig. 3).