Introduction:

currently, internal iliac artery aneurysms are generally treated with endovascular techniques, in patients with previous interventions it can be particularly challenging to treat these lesions due to lack of a patent “classical” access site.

Case report:

we report a case of an 80-year-old man with a growing right internal iliac aneurysm, in which a percutaneous antegrade access through the iliac artery or a retrograde access to the femoral artery were impossible due to previous interventions, that was managed with trans catheter coil embolization with a percutaneous puncture to the superior gluteal artery.

Discussion:

when classical endovascular approaches to the intern iliac artery are absent, the transgluteal puncture is a simple and replicable technique, offering an alternative in challenging scenarios.

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