Hybrid Treatment of an Enlarging Hypogastric Aneurysm Previously Excluded During Abdominal Aortic Aneurysm Repair.

Hypogastric aneurysm is rare, often asymptomatic, but associated with high mortality if it ruptures. Given the deep location of the artery and proximity to critical anatomical structures (i.e., ureter, bladder, and rectum), open surgical repair carries high morbidity and mortality compared with an endovascular approach. We report a simple hybrid approach to repair an enlarging isolated hypogastric aneurysm after a previous aortic aneurysm repair during which the origin of the hypogastric artery was ligated.