True superior gluteal artery aneurysm

Abstract

Gluteal artery aneurysms (GAAs), classified as true or false, account for <1% of all aneurysms. Of the 175 GAAs reported in the English literature, 20 are true aneurysms, making this case the twenty-first reported true aneurysm and sixth of atherosclerotic origin. We report a true GAA in a 72-year-old woman. Pelvic computed tomography suggested GAA (7.2 × 4.9 cm); subsequently, an endovascular approach allowed definitive diagnosis and treatment—coil embolization. In accordance with the literature and the surgical and clinical success of our case, endovascular embolization of GAAs has emerged as an effective and safe treatment.

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

“…The aneurysm causes compression of the sciatic nerve giving rise to the characteristic pain that arises in the ipsilateral buttock and radiates down the thigh and knee. Symptoms of limb ischaemia can arise due to thrombosis or distal embolism [ 1 ] just like in our patient who had diminished ipsilateral dorsalis pedis pulse and recurrent pedal arterial ulcers. The aneurysms are expected to be pulsatile when examined.…”

“…Most aneurysms of the gluteal artery are pseudo-aneurysms caused by blunt or penetrating trauma from falls on the buttock [ 2 ], pelvic surgeries, pelvic fractures, intramuscular injections etc. True aneurysms are rare with only twenty-one previously reported cases [ 1 ]. The commonest true SGA aneurysms are of mycotic origin secondary to intravenous drug abuse [ 3 ] or infective endocarditis [ 4 , 5 ].…”

“…The commonest true SGA aneurysms are of mycotic origin secondary to intravenous drug abuse [ 3 ] or infective endocarditis [ 4 , 5 ]. True atherosclerotic SGA aneurysms have been described, some from histological examination of resected tissue [ 4 ] and others from clinical and morphological features of the aneurysm [ 1 ]. Immunosuppression has been reported, albeit in the inferior gluteal artery, to be a risk factor for non-typhi Salmonella induced gluteal aneurysm [ 6 ].…”

“…A true aneurysm of the superior gluteal artery (SGA) is a rare clinical condition with only twenty-one previously reported cases [ 1 ] in the English-language literature. Complications include compressive symptoms, rupture with exanguination, insitu thrombosis and embolic phenomena causing limb ischaemia.…”