True Aneurysm of the Inferior Gluteal Artery: Case Report and Review of the Literature

True superior gluteal artery aneurysm with neurovascular compromise of the lower limb: a case report and review of the therapeutic options

“…Surgical treatment : Currently, the two-staged extraperitoneal approach is favoured [ 11 , 12 , 15 ]. Transperitoneal approaches have also been described but the former has the advantage of avoiding entry into the abdomen hence precluding potential intra-abdominal abscesses and other complications.…”

“…The sciatic nerve forms part of the wall of the sac and should be identified and separated from the sac. True gluteal aneurysms that are solely extra pelvic have been managed from a gluteal approach alone [ 12 , 15 ]. Surgery enables early resolution of symptoms caused by compression or displacement of adjacent structures [ 16 ].…”

True superior gluteal artery aneurysm

“…Most GAAs are pseudoaneurysms, with a mechanism of trauma; leading causes are pelvic fracture, perforating injury, and iatrogenic origin 10 . True aneurysms are extremely rare, with reported causes being mycotic,2, 11, 12, 13, 14, 15, 16 atherosclerosis,4, 6, 10, 17, 18 polyarteritis nodosa, 5 arteriovenous malformation, 19 and intimal-medial mucoid degeneration 20 . The most common etiology of true aneurysms is mycotic.…”

“…The effectiveness of the endovascular approach is due to elimination of arterial pressure and post-thrombotic tissue remodeling; therefore, timing of symptom resolution may not be immediate as expected in an open approach 12 . Endovascular modalities of transcatheter embolization include the following: hemostatic agents, such as thrombin injection, Gelfoam (Pfizer, New York, NY), and Floseal (Baxter International Inc, Deerfield, Ill); coils; stent-graft placement; thrombosis by 48-hour balloon occlusion; sclerotherapy; and vascular plugs 2, 16, 17, 18. This particular case used transcatheter coil embolization.…”

“…This particular case used transcatheter coil embolization. From 1977 to 1995, transcatheter embolization was tried in 7 of 19 documented cases 6 ; however, from 1995 to 2015, transcatheter embolization was the definitive treatment in 44 of 53 GAA cases 2, 4, 7, 15, 16, 17, 18, 19, 20…”