Young age patient with aortic and bilateral iliac artery aneurysm: risk factors and strategy of endovascular treatment – case study


1Rytis Kijauskas, 1Milda Staniulytė

1Academy of Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania



Aim: To present a clinical case in which abdominal aortic aneurysm (AAA), common iliac artery (CIA) and internal iliac artery (IIA) aneurysms were cured for an unusually young patient, to discuss the methods of treatment and to present their results.

Case report: A 57-year-old man was presented at LUHS Kaunas Clinics Department of Vascular Surgery in 2014 with bilateral CIA stenosis. In 2016, he was presented again because of acute thrombosis of his left superficial femoral artery. Femoropopliteal bypass was formed and popliteal artery aneurysm (PAA) was resected. In 2017, an identical procedure was made on his right leg. In 2019, a Computer Tomography (CT) scan showed a widened infrarenal aneurysm (from 56 mm to 88 mm of length), changes in both CIA (23 mm and 23 mm respectively) and bilateral IIA (19 mm on the right side and 23 mm on the left side) so a spiral embolization of bilateral IAA was performed. In 2020 02 14 an endovascular artery repair (EVAR) was performed placing an aorto-bi-iliac stent graft.

Conclusion:  According to the prevalence of AAA and IAA, the patient (57 years old) was unusually young to experience the occurrence of these pathologies (> 65 years). He had some typical risk factors: male gender, arterial hypertension, dyslipidaemia. PAA was treated by forming a femoropopliteal bypass, bilateral IIA were embolised using spirals, and CIA and aorta were treated by using EVAR aorto-bi-iliac endograft.

Keywords: aortic aneurysm, iliac artery aneurysm, young age, endovascular treatment.