case_images: PMC11667059_01
case_images: Large partially thrombosed right internal iliac artery aneurysm.
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case_images: During work-up for future transplant, a lower limb CT angiogram was done and revealed an incidental finding of a large partially thrombosed internal iliac artery aneurysm measuring 10 x 10 x 7.7 cm compressing the right common and external iliac veins as well as the external iliac artery with no signs of impending rupture (Fig. 1).
case_images: (A) Angiogram before stenting. (B) Completion angiogram revealed no flow to the aneurysmal sac.
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case_images: The completion angiogram confirmed the absence of flow into the aneurysm with no signs of endoleak (Fig. 2A and B).
case_images: Increase in the size of the previously excluded right internal iliac artery aneurysm.
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case_images: A CT angiogram was conducted and showed an increase in the size of the previously excluded right internal artery aneurysm to 12.9 x 10 cm (Fig. 3).
case_images: A and B: Type IIa endoleak via right profunda femoris artery (white arrow).
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case_images: It was observed that contrast was pooling within the aneurysm, with pelvic and thigh collaterals originating from the proximal right profunda femoris artery supplying the aneurysm (Fig. 4A and B), and therefore, the branch was embolized and despite that, type IIa endoleak persisted in the follow-up CTA.
case_images: (A) A large internal iliac aneurysm occupying most of the patient's pelvic cavity. (B) Large thromus in the aneurysmal sac. (C) The thromus. (D) Closure of the aneurysmal sac.
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case_images: Dissection was carried around the aneurysm, and the aneurysmal sac was opened (Fig. 5A and B). A large thrombus was seen and removed, the feeding branch was suture ligated then the sac was closed (Fig. 5C and D).