Type IA endoleaks associated with endovascular aortic aneurysm repair are typically treated with endovascular adjuncts. Technical failure results when such maneuvers are unsuccessful, and endograft removal may, unfortunately, become necessary. The novel management of a recalcitrant type IA endoleak using the artificial embolization device, Onyx (Micro Therapeutics Inc, Irvine, Calif) is presented for the case of a nonagenarian with prohibitive surgical risk after conventional techniques had failed.
Profunda femoris artery (PFA) pseudoaneurysm after blunt trauma without associated femur fracture is a rare occurrence. Most of the reported cases of PFA pseudoaneurysm in the English literature developed after penetrating trauma, surgical procedures, and femur fractures. We present two such cases following blunt trauma and without any associated long bone injury. After initial imaging failed to show any long bone fracture, CT angiography confirmed pseudoaneurysm of the branch of the PFA. Both patients were then treated with emergent coil embolization of the bleeding vessel. Pseudoaneurysms typically present late and signs of persistent hip pain, thigh swelling, presence of a pulsatile mass, and even unexplained anemia all may suggest the diagnosis. Recognition of PFA pseudoaneurysm requires high index of suspicion and is often difficult to diagnose clinically because of its location.
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