PMC3277481_01
Aortogram demonstrating a large right common iliac artery aneurysm with simultaneous contrast opacification of his inferior vena cava.
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An aortogram then demonstrated the large right common iliac artery aneurysm and associated iliocaval fistula (Figure 1).
Arch aortogram demonstrating the right-sided central venous catheter entry site into his right common carotid artery and the tip in his innominate artery.
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CCA was then achieved with a Cook Shuttle sheath (Bloomington, IN, USA). Carotid angiography demonstrated the catheter entry point into his mid-right CCA (Figure 2).
Selective right carotid angiogram after removal of the central venous catheter, demonstrating contrast extravasation in his neck and opacification into his internal jugular vein.
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The catheter was removed and angiography revealed a carotid-to-jugular arteriovenous (AV) fistula (Figure 3).
Selective right carotid angiogram after three-minute common carotid artery balloon angioplasty, demonstrating no further contrast extravasation.
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Subsequent angiography revealed a widely patent carotid artery with no AV fistula or contrast extravasation visible (Figure 4).
Three-dimensional volume reconstruction of a postoperative computed tomography angiogram, demonstrating an excluded right common iliac artery aneurysm with an aortoiliac stentgraft extending into the right external iliac artery and retrograde filling of the distal right internal iliac artery.
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Our patient was transferred back to his regional hospital after a satisfactory progress CT angiogram (Figure 5) and was discharged home three weeks later.
Maximum intensity projection reconstruction of a postoperative computed tomography angiogram, demonstrating thrombus in the right common iliac artery aneurysm sac with no evidence of endoleak and retrograde filling of the right internal iliac artery stump.
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At six-week follow-up there remained no evidence of endoleak on a progress CT angiogram (Figure 6).