J Lipid Atheroscler.  2014 Jun;3(1):49-53. 10.12997/jla.2014.3.1.49.

Endovascular Management of Spontaneous Superficial Femoral Artery Pseudoaneurysm in a Renal Allograft Patient

• Lee YB
• Cho YH
• Lee JH
• Lee JH
• Kim MS
• Kim JH
• Lim CW
• Choi YH
• Lim GM

• KMID: 2198361
• DOI: http://doi.org/10.12997/jla.2014.3.1.49

Abstract

We report a case of a superficial femoral artery pseudoaneurysm in 52-year old patient with a history of having renal allograft. The pseudoaneurysm spontaneously developed while standing up from squatting position after defecation, and it was successfully managed by an endovascular repair with an endograft. This case suggests that an atherosclerotic superficial femoral artery is vulnerable to torsion and tension movement during changing position from squatting to standing, which is repeatedly practiced by the people using the Korean traditional toilet. The endovascular therapy is also recommended for elderly patients with poor clinical conditions such as having a renal allograft and diffuse atherosclerosis of peripheral arteries.

Keyword

Pseudoaneurysm; Superficial femoral artery; Renal allograft; Endograft

MeSH Terms

Aged
Allografts*
Aneurysm, False*
Arteries
Atherosclerosis
Defecation
Femoral Artery*
Humans

Figure

• 

  Fig. 1 Vascular ultrasound of the left thigh before endovascular treatment is shown. (A) The initial vascular ultrasound of the left thigh sonography showed a large (11.2×6.8×12 cm) hematoma including a 1.8×1.3 cm-sized pseudoaneurysm, (B) The pseudoaneurysm was communicated with the left superficial femoral artery, suggesting a spontaneous rupturing of left superficial femoral artery.

• 

  Fig. 2 Endovascular treatment of the pseudonaeurysm of left superficial femoral artery. (A) The peripheral angiography showed a pseudoaneurysm at the distal part of the left superficial femoral artery, (B) A self-expanding stent-graft (Viabahn® self-expanding stent-graft (8-mm diameter × 150-mm length)) was deployed to cover the pseudoaneurysm, and it was dilated and modeled by a 8 mm balloon, (C) The final angiography revealed a complete exclusion of the pseudoaneurysm.

• 

  Fig. 3 Vascular ultrasound of the left thigh after endovascular treatment. The vascular ultrasound after endovascular treatment demonstrated a complete thrombosis of the pseudoaneurysm.

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