A vascular anomaly of the iliac artery in a patient with VATER association

VATER association has been coined from a random combination of the initials of vertebral defects, anal atresia, tracheoesophageal fistula with esophageal atresia, and radial or renal dysplasia. At least two anomalies indicate a definitive diagnosis of VATER association. In a patient who underwent interventional radiology for minor intestinal bleeding, we observed a traveling abnormality of the right iliac artery. This patient had the defective right external iliac artery and migration of internal iliac artery directly to the femoral artery. VATER association is referred to as VACTERL association when it is combined with heart malformations and limb anomalies. From the embryological viewpoint, the mesoderm is derived from the heart and blood vessels. Hence, the combination of this vascular malformation was considered one of the phenotypes of VATER association. A common iliac artery abnormality may be added as a new malformation complicated with VATER association. The term “VATER” association was coined from the combination of the initials for vertebral defects (V), anal atresia (A), tracheoesophageal fistula with esophageal atresia (TE), and radial or renal dysplasia (R). The presence of at least two anomalies indicates a definitive diagnosis of VATER association, according to Quan and Smith (1972) 8. When VATER association occurs with heart malformations and limb anomalies, it is called VACTERL association 1. Only one case of an external iliac artery‐deficient vascular malformation occurring with VACTERL association has been previously reported 2. This report described an abnormality of the right external iliac artery in a patient with VATER association who needed renal transplantation, and showed the usefulness of reconstructed computed tomography (CT) for selecting the anastomotic vessel. From an embryological viewpoint, the heart and blood vessels are derived from the mesoderm. We observed a traveling abnormality of the right iliac artery in a patient who had VATER association and underwent interventional radiology for minor intestinal bleeding. Hence, this combination with a vascular malformation was considered one of the VACTERL association phenotypes.