PMC4857320_01
CT angiography demonstrated total occlusion of the right common iliac artery and the origin of internal and external iliac arteries without collaterals.
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Computed tomography (CT) angiography showed that there was complete occlusion of the right common iliac artery and the beginning of internal and external iliac arteries, with no collateral circulation from the contralateral side (Figure 1), which caused narrowing of arteries of the right lower extremity.
DSA demonstrated total occlusion of the right common iliac artery and the origin of internal and external iliac arteries without collaterals.
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The patient underwent an emergency digital subtraction angiography (DSA; Figure 2) and catheter-directed thrombolysis combined with balloon angioplasty.
Balloon angioplasty following catheter-directed thrombolysis.
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Then, a balloon was used to get patent recanalization (Figure 3), followed by urokinase 500,000 units pumped into the right common iliac artery for 24 h.
Angiography demonstrated complete patency of the right common iliac artery, internal and external iliac arteries 24 h after balloon angioplasty and catheter-directed thrombolysis.
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Post-procedure angiography demonstrated smooth blood flow without filling defects in the previously occluded arteries (Figure 4).