Percutaneous intervention for chronic total occlusion of the internal iliac artery for unrelenting buttock claudication.

Internal iliac artery stenosis or occlusion has been documented to cause hip pain, erectile dysfunction, and buttock claudication. Endovascular repair for patients with significant stenosis has been well documented, but chronic total occlusion revascularizations have not been reported in the literature. The reluctance to attempt percutaneous intervention may be in part due to the extensive collateralization that forms to this vessel, or fear of complications such as wire perforation in a vessel that has a tortuous route with multiple bifurcations. This report describes two cases of patients with unrelenting buttock claudication that completely resolved after percutaneous intervention of unilateral chronic total occlusions of the internal iliac artery.