Coil embolization of an infected superior gluteal artery pseudoaneurysm caused by methicillin-resistant Staphylococcus aureus

Abstract

We describe the successful selective coil embolization of an infected superior gluteal pseudoaneurysm secondary to methicillin-resistant Staphylococcus aureus (MRSA) in a 36-year old women. The patient presented with a long history of drug abuse and perisacral abscesses due to chronic sacroilitis. The chosen strategy provides a safe and successful management of infected false gluteal artery aneurysm.

Mycotic aneurysm of the superior gluteal artery in a patient with bacterial endocarditis: case report and review of the literature

“…The risk of persistent infection following embolization of mycotic aneurysms remains since the procedure puts ‘foreign material’ into a potentially infected site. However, the results of our case and the cases reported 3,4,6,7 suggest that this approach for treating mycotic aneurysms is an acceptable treatment considering the benefit of avoiding open surgical repair and the effectiveness of the endovascular treatment.…”

“…All eight SGA aneurysms reported since 1995 were treated endovascularly, with excellent results. 3,4,[8][9][10][11][12][13] It has been speculated that symptoms related to an SGA aneurysm can be relieved by the abolition of arterial pressure and the tissue remodeling that occurs after thrombosis of the lesion. Indeed, the buttock pain in our patient had ceased completely within a few months of the embolization of the SGA aneurysm.…”

“…A 1995 review by Schorn et al 1 identified 123 reports of gluteal artery aneurysms, and eight additional SGA aneurysms have been described since then. 3,4,8–13 Aside from trauma, causes of SGA aneurysm include infection (mycotic aneurysms), 3–7 atherosclerosis, 1,8 polyarteritis nodosa 14 and intimomedial mucoid degeneration. 9 Mycotic aneurysms occur in approximately 15% of patients with bacterial endocarditis, 3 but remain rare and generally affect the aorta.…”

“…2 So far, only five mycotic aneurysms of the SGA have been reported in the medical literature in English. [3][4][5][6][7] We describe a 64-year-old man who had mycotic aneurysms of both the SGA and the superior mesenteric artery (SMA). The lesions were treated successfully with a combination of endovascular and open surgical therapy.…”

Thrombin Injection for the Treatment of Mycotic Gluteal Aneurysm

“…2 Pelvic fractures usually damage the inferior gluteal artery or its branches, whereas penetrating injuries affect the superior gluteal artery. 3 They present as painful pulsatile swelling in the buttock with or without symptoms of sciatic nerve compression. If mistakenly diagnosed as buttock abscess, a catastrophic result may follow.…”