Atheroembolization: A harmful complication of therapeutic internal iliac artery occlusion

Abstract

Coil embolization of the internal iliac artery (IIA) for proper endovascular treatment of aortoiliac aneurysms is a procedure with an acceptable morbidity rate consisting of buttock claudication in 12% to 55% and erectile dysfunction in 1% to 13%. Atheroembolic complications in this context are not yet reported. We present a case with gangrene of the prepuce and focal cutaneous necrosis of the ipsilateral buttock and foot after coil embolization of one IIA. Multiple atheroemboli were found with the histopathologic examination of the excised prepuce. Atheroembolization is a rare complication of therapeutic IIA occlusion, and the ischemic sequels can be severe because of the coincidence of atheroembolization and occlusion of the main supplying artery.