case_images: PMC10687451_01
case_images: A 3.1 cm x 2.9 cm right common iliac artery aneurysm allowing for a compressive force on the bilateral iliac veins, as illustrated by the arrows.
case_images: fcvm-10-1279981-g001.jpg
case_images: PMC10687451_01_fcvm-10-1279981-g001.jpg
case_images: F1
case_images: Figure 1. Further investigation was sought with invasive maneuvers, as discussed in management.
case_images: (A) Right CIA aneurysm causing compression of bilateral CIVs and resultant thrombosis. (B) Arterial angiogram showing a similar size and shape of the aneurysm that matches the lucency seen in (A). (C) Post-successful bilateral lower-extremity mechanical thrombectomy using Inari ClotTriever, followed by bilateral VICI venous stenting with an extension of the stent on the right lower extremity with a Wallstent under IVUS guidance.
case_images: fcvm-10-1279981-g002.jpg
case_images: PMC10687451_01_fcvm-10-1279981-g002.jpg
case_images: F2
case_images: The patient was taken to the catheterization laboratory where a venography revealed a significant area of overlying mobile lucency that appeared to be above the venous confluence, as illustrated in Figures 2A,B. To prevent continued compression, we elected to place bilateral kissing venous stents using IVUS guidance with bilateral 16 mm x 120 mm VICI (Boston Scientific, Marlborough, MA, USA), right-sided 16 mm x 90 mm VICI, and left-sided 16 mm x 90 mm Wallstent (Boston Scientific, Marlborough, MA, USA), as shown in Figure 2C.
case_images: (A) The compressive effects of the right CIA on the bilateral iliac veins. (B) 4-month post-bilateral iliac venous stenting showed venous stent patency but also demonstrated an interval increase in right CIA aneurysm size. (C) 12-month follow-up from initial venous intervention demonstrates a progression in aneurysmal size. (D) 1-month post-stenting to the right common iliac artery stent graft traversing the aneurysm with a noticeable thrombus of the aneurysm sac and patent iliac artery stent.
case_images: fcvm-10-1279981-g003.jpg
case_images: PMC10687451_01_fcvm-10-1279981-g003.jpg
case_images: F3
case_images: Follow-up imaging 6 months later demonstrated an increase in the size of the right CIA aneurysm (Figures 3B,C). Follow-up CTA demonstrated a regression and thrombosis of the aneurysm and patent, well-aligned venous stents, Figure 3D.
case_images: 3D reconstruction of the arterial system. (A) Initial imaging revealing the right CIA aneurysm. (B) 18 months post-covered stenting shows a complete resolution of the aneurysm.
case_images: fcvm-10-1279981-g004.jpg
case_images: PMC10687451_01_fcvm-10-1279981-g004.jpg
case_images: F4
case_images: The near resorption of the native aneurysm sac can be discerned from Figures 4A,B.