True aneurysm of the superior gluteal artery: Case report and review of the literature

Abstract

Aneurysms of the gluteal arteries are rare and mostly are caused by pelvic fractures or penetrating injuries. As such these aneurysms are pseudoaneurysms. As an absolute rarity we report the case of a 43-year-old man with a histologically verified 5 cm-diameter, true saccular aneurysm of the left superior gluteal artery. The patient was admitted with 6-weeks ongoing sciatic pain without previous trauma. He was scheduled for surgery because an initial attempt of transcatheter embolization failed. By dividing the origin of the gluteus maximus muscle from the iliac crest, the aneurysm was exposed at the pelvic outlet by an extrapelvic approach and was excluded by endoaneurysmorrhaphy. Uncontrolled bleeding was prevented by temporary occlusion of the left iliac artery by a percutaneously inserted balloon catheter, thus avoiding an additional retroperitoneal approach. The postoperative course was uneventful, and sciatic pain had resolved completely. The chosen strategy provides safe and successful surgical management of gluteal artery aneurysms.

The Vascular Supply of Hip Joint and its Clinical Significant

“…Then, series studies have been reviewed on aneurysm of superior gluteal artery by Schorn et al (1995) and inferior gluteal artery by Keeling et al (2008) due to trauma. There is no clear incidence of gluteal artery aneurysm (Schorn et al, 1995) but it is occurred more men than women.…”

“…Then, series studies have been reviewed on aneurysm of superior gluteal artery by Schorn et al (1995) and inferior gluteal artery by Keeling et al (2008) due to trauma. There is no clear incidence of gluteal artery aneurysm (Schorn et al, 1995) but it is occurred more men than women. Based on previous studies, the superior gluteal artery is highly predisposed to aneurysm than the inferior gluteal artery (Smyth et al, 1965;Matas, 1909 ( Song et al, 2006).…”

Inferior gluteal artery pseudoaneurysm mimicking gluteal abscess

“…The majority of these are pseudoaneurysms. The superior gluteal artery (large terminal branch of posterior trunk of internal iliac artery) is more commonly involved than the inferior gluteal artery (large terminal branch of anterior trunk of internal iliac artery) [2,3,8]. A gluteal artery pseudoaneurysm presents as an insidious onset, gradually progressive, post-traumatic swelling in the gluteal region, arising within a few weeks or months or years after the primary insult [1,2,9].…”

“…The swelling may show signs of infl ammation, may or may not be pulsatile and thus may very well mimic a gluteal abscess or might be erroneously diagnosed as sarcomata, lipomata, or hernia [8,9,10]. It might also present as compressive neuropathy of the sciatic nerve [3,9]. In its extrapelvic course inferior gluteal artery is mostly localized medially to nerve.…”

“…The aneurysms of superior gluteal artery are more common than inferior gluteal artery [2,3]. The aneurysms of the inferior gluteal artery predominantly occur due to blunt or penetrating trauma [4].…”