A novel endovascular technique in the management of a large internal iliac artery aneurysm associated with an arteriovenous fistula.

PURPOSE: To describe a novel endovascular technique in the management of a complex arteriovenous fistula between a large internal iliac artery aneurysm and the adjacent iliac vein in a 76-year old patient with previous aortobifemoral bypass graft with an occluded proximal common iliac artery.

CASE REPORT: Due to the high risk of open surgery in this case, endovascular treatment with simultaneous venous and arterial access was performed, with implantation of 2 stent grafts in the iliac vein to cover the fistulous communication and embolisation of the native external iliac artery (inflow).

CONCLUSION: The endovascular technique described enables thrombosis of the large internal iliac aneurysm and treatment of the arteriovenous fistula without exposing the patient to the high morbidity and mortality associated with open surgery.