Successful Repair of an Arterio-Vesical Fistula as a Complication after Coil Embolization for Right Hypogastric Artery Aneurysm

Abstract This is an 84-year-old male with a history of a right hypogastric artery aneurysm that was excluded with endograft several years ago. His course was complicated by a type II endoleak with enlarging aneurysm that required multiple attempts of coil embolization. Several years later he presented with gross hematuria, and was found to have embolization coils extruding into his bladder and an arterio-vesical fistula. As seen in this case, endovascular intervention of type II endoleak is not benign. We describe a novel complication of an arterio-vesical fistula that necessitated a difficult repair and ultimate revascularization.