Deep Circumflex Iliac Artery as a Cause of Type II Endoleak

Abstract

PURPOSE To report a collateral pathway involving the deep circumflex iliac artery causing a type II endoleak following endoluminal exclusion of an abdominal aortic aneurysm (AAA). CASE REPORT A 75-year-old man was investigated for a persistent type II endoleak 2 years after endovascular AAA repair with a Zenith Trifab stent-graft. Angiography revealed contrast in the sac from a lumbar artery fed via a collateral of the deep circumflex iliac artery. The lumbar artery was embolized with coils, but an endoleak persisted and is being followed. CONCLUSIONS This collateral pathway is easily missed during angiography for endoleaks and should be considered where an endoleak is suspected but cannot be found.