Use of FloSeal (R) in the endovascular treatment of voluminous aneurysm of a lower gluteus artery

We suggest an alternative endovascular treatment for gluteal artery aneurysm using Floseal (R) a matrix of bovine gel and thrombin component. A 70-year-old woman, presented with claudicatio of the lower left limb after 150 m walking and pain at the sciatic nerve irradiation. A pulsating and painful mass was present in the lower gluteal region. No history for previous trauma, nor for orthopedic surgery. The suspect of aneurysm of the left gluteal artery was confirmed by Color Doppler Ultrasound and by computed tomography (CT) showing a fusiform aneurysm in the lower gluteus artery. In order to rule out infective cause, blood coltures were taken. Compression of the sciatic nerve was confirmed by electromyography study. Patient was treated by endovascular treatment. We performed angiography, with a selective study of the lower left gluteus artery, and embolization of the aneurysm by an injection of FloSeal (R) (hemostatic) and fibered platinum coil. At the discharge, we observed absence of pulsation in gluteus region and the complete resolution of clinical symptom. The Color Doppler Ultrasound scan showed a complete occlusion of the aneurysm. This case appears quite peculiar, for the absence of any pelvic trauma, orthopedic operations or previous penetrating lesions, responsible of vascular lesions as reported in literature. The large aneurysm dimensions made the embolization procedure quite difficult, and brought us to use FloSeal (R). The treatment we proposed may be useful in the treatment of peripheral aneurysms of great dimension, and may be an alternative to the more traditional ones.