This report aims to discuss a case of aortoiliac rupture during percutaneous transluminal angioplasty (PTA). The incidence of this type of rupture during PTA is low, specifically in the external iliac artery (EIA). We present the case of a 57-year-old male, a former smoker, with a history of metastatic cancer, who underwent PTA for severe limb-threatening ischemia. He experienced rupture in the left common iliac artery (CIA), which was promptly ligated. Emphasis is initially placed on examining the interplay between the lesion and the device, factors leading to the complication. Further discussion explores preprocedural imaging and alternative endovascular procedures, including primary stents, surgical grafts, and lithotripsy.
Garrison et al. (2026) studied this question.