Percutaneous Stent-Graft Repair of Anastomotic Pseudoaneurysms following Vascular Bypass Procedures: A Report of Two Cases
Figure 2
(a) A CT scan shows a large vascular mass in the left groin (arrows) consistent with an aPSA in this patient with an aortobifemoral bypass. (b) Angiography of the left iliac limb of the ABF via a brachial approach shows a left femoral aPSA (asterisk). Note the small caliber atherosclerotic profunda femoral artery (arrow) as well as SFA occlusion. (c) Follow-up angiogram after initial self-expandable and sequentially dilated balloon expandable stent-grafts shows diminished filling of the aPSA with persistent perigraft leak (arrow). (d) Repeat angiography following additional larger dilation of the cephalad iCast stent graft now shows nonfilling of the aPSA. (e) An angiogram performed via direct puncture of the sPSA after iliac and profunda femoral stent-graft placement shows communication between the pseudoaneurysmal sac and the EIA (arrow). (f) Angiography after coil embolization of the EIA. A subsequent ultrasound showed complete exclusion of flow in the aPSA.
