Early Postoperative Simultaneous Occlusion of the Internal and External Iliac Artery Limbs after GORE Excluder Iliac Branch Endoprosthesis Implantation.

An 85-year-old man underwent endovascular repair using the Excluder iliac branch endoprosthesis (IBE) for an abdominal aortic aneurysm with a left internal iliac artery aneurysm. He was discharged uneventfully but returned on postoperative day 16 with acute left limb occlusion. Imaging revealed complete occlusion of both the internal and external iliac limbs of the IBE, requiring emergent thrombectomy. Intraoperative assessment demonstrated mechanical compression of the external iliac limb by the internal iliac limb, causing stenosis and thrombosis. This rare complication highlights the importance of meticulous preoperative planning to prevent limb-related events, particularly in patients treated outside the device's indications.