A 69-Year-Old Man with a Painful Gluteal Mass due to a Superior Gluteal Artery Pseudoaneurysm Treated with Endovascular Repair

Abstract

Background: Arterial pseudoaneurysm, or false aneurysm, results from damage to the arterial wall, usually due to trauma or infection. Gluteal artery aneurysm is a rare condition with a frequency of less than 1% of all aneurysms. It occurs mainly as a complication of trauma. More seldom they are formed as a consequence of infections. The endovascular treatment is regarded as the gold standard. This report is of the case of a 69-year-old man with a painful gluteal mass due to a superior gluteal artery pseudoaneurysm treated with endovascular repair. Case Report: A 69-year-old Caucasian male suffered from pain, feeling pressure and a pulsating mass in the left gluteal area for 6 months. There were no signs of infection in the laboratory tests. Magnetic resonance imaging (MRI) revealed a 35 mm contrast accumulating mass in the left superior gluteal artery (SGA). Scintigraphy with 99m-technetium-hexamethylpropylamineoxime (Tc- 99m-HMPAO) labeled lymphocytes revealed the inflammatory character of the described abnormality. The pseudoaneurysm was secondary to endocarditis, which patients underwent oneyear earlier. After cross-type catheterization of the right internal iliac artery digital subtraction angiography (DSA) revealed a 35mm pseudoaneurysm of the left superior gluteal artery. The mass was embolized distally and proximally. Control arteriography confirmed the effectiveness of the procedure. A control magnetic resonance angiography (angio-MR) study after three months proved complete pseudoaneurysm exclusion. Postoperative complications were not observed. Conclusion: The endovascular treatment such as coil embolization of gluteal artery pseudoaneurysm is a safe and sufficient method, especially when performed on patients with many comorbidities e.g. as hypertension, heart insufficiency, and atrial fibrillation.