Endovascular interventions for human immunodeficiency virus-associated iliac artery aneurysms

Abstract

OBJECTIVE: Aneurysms associated with human immunodeficiency virus (HIV) are pseudo-aneurysms and the pathology is unique to HIV vasculopathy. We report outcomes of endovascular therapy for HIV iliac artery aneurysms in a series of patients to augment the sparse literature on these aneurysms. METHODS: The records from January 2010 to December 2013 of all patients treated for HIV-related iliac artery aneurysms were extracted from a prospectively maintained database at our institution. RESULTS: Preprocedural, periprocedural, and postprocedural data were retrieved for five black patients (three males and two females), who were treated for HIV-associated iliac artery aneurysms. All patients underwent endovascular therapy. There were seven aneurysms (three common iliac arteries, three internal, and one external). Pain was a common presenting feature, and two patients presented with rupture. One patient was receiving antiretroviral therapy, and one patient was receiving treatment for pulmonary tuberculosis. Three patients had significant weight loss. The average hemoglobin value was 8 g/dl. Six aneurysms were managed with covered stents and one (internal iliac artery) with coil embolization. There were no procedure-related complications, and only one patient required a blood transfusion. Symptoms resolved in all patients. One re-intervention was required for stent thrombosis after 30 days. CONCLUSION: Endovascular therapy for the HIV-associated iliac artery aneurysm has good short-term results and avoids pelvic dissection with its associated morbidity and mortality.