We report a case of a 77-year-old female with type II endoleakage due to recanalization of a coil-embolized internal iliac artery. The patient had undergone endovascular aneurysmal repair (EVAR) for an abdominal aortic aneurysm (5.0 cm in diameter) 4 years back. Because of the right common iliac artery aneurysm, coil embolization to the right internal iliac artery had been simultaneously performed. The diameter of the aneurysm had increased annually after EVAR, and reached 5.7 cm at the time of presentation. Contrast-enhanced computed tomography revealed a moderate amount of type II endoleakage from the right internal iliac artery. Selective angiogram showed the recanalization of the right internal iliac artery, which was once embolized completely. Repetitive coil embolization seemed difficult, because the recanalized artery was fed with multiple narrow, curved collateral vessels. We, therefore, ligated the orifice of the right internal iliac artery via the retroperitoneal approach. No endoleakage from the right internal iliac artery was detected in the final angiogram.
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