Case Reports

AORTA, Article in Press
DOI: 10.12945/j.aorta.17.036

Persistent Buttock Claudication After EVAR: A Surgical Solution

Alessandro Robaldo, MD, Stefano Pagliari, MD, Filippo Piaggio, MD, Patrizio Colotto, MD

Vascular and Endovascular Surgery Unit, Imperia Hospital, Imperia, Italy

Abstract

We describe the successful therapeutic application of a surgical technique to treat a 71-year-old man affected by right buttock claudication (BC) after a right internal iliac artery (IIA) coil embolization as an adjunct to endovascular iliac artery aneurysm repair. The CT-angiogram revealed extensive aortoiliac calcifications and thrombus in the vessel walls. Despite patency of the controlateral IIA and the preservation of the right distal collateral flow through the ipsilateral hypogastric branches, the symptom was persistent and disabling. The high-risk patient underwent an “open” repair of the infrarenal abdominal aneurysm with removal of the entire stent-graft and concomitant revascularization of the right IIA. Post-operative recovery was uneventful and the patient remained asymptomatic during a 30-month follow-up. This case underscores the importance to consider all potential solutions, including open surgery, to preserve pelvic inflow after aortoiliac stent grafting, in particularly, in high risk patients with vulnerable plaque and higher risk of thrombus embolization.

Cite this article as: Robaldo A, Pagliari S, Piaggio F, Colotto P. Persistent Buttock Claudication After EVAR: A Surgical Solution. Aorta (Stamford). DOI: 10.12945/j.aorta.17.036 [In Press]

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