Intraprocedural Safety and Technical Success of the MVP Micro Vascular Plug for Embolization of Pulmonary Arteriovenous Malformations.

This case series describes early experience, intraprocedural safety, and technical success of the MVP Micro Vascular Plug (MVP; Covidien, Irvine, California) for embolization of 20 pulmonary arteriovenous malformations (PAVMs) using 23 plugs in seven patients with hereditary hemorrhagic telangiectasia. There was no device migration, and all devices were successfully detached electrolytically. Immediate cessation of flow through the feeding artery was achieved in 21 of 23 (91%) deployments. There was one minor complication. This series demonstrates the MVP to be safe and technically successful in the treatment of PAVMs.

Acute thrombosis of an abdominal aortic aneurysm followed by delayed rupture associated with bacterial infection.

Sudden thrombosis of an abdominal aortic aneurysm (AAA) is distinctly rare and is associated with up to 50% mortality. Almost equally rare is infection of a preexisting AAA. We report an extremely unusual case of an AAA that thrombosed leading to acute limb ischemia. This was followed several months later by a delayed rupture of the thrombosed AAA associated with an Escherichia coli infection. We suspect the aortic thrombus was hematogenously seeded by a urinary tract infection. A review of the literature revealed that bacterial infection of a previously thrombosed AAA, leading to a delayed rupture, has not been previously reported.

Popliteal artery pseudoaneurysm after isolated hyperextension of the knee.

We report an unusual case of a traumatic pseudoaneurysm of the popliteal artery after an isolated blunt hyperextension injury to the knee. A 56-year-old man presented with a 1-month history of left knee pain that occurred after a fall onto his buttocks with hyperextension of the knee while transferring a relative out of a wheelchair. A large pulsatile mass in the posterior aspect of the left knee was palpated on physical examination, although he had warm distal extremities and 2+ distal pulses bilaterally. Magnetic resonance angiography revealed a 7.6 × 6.2 × 4.9 cm left popliteral artery pseudoaneurysm, which was subsequently treated with aneurysm exclusion with end to end reverse saphenous vein graft bypass. The development of a popliteal artery pseudoaneurysm after blunt knee injury without dislocation, fracture, or ligament injury is extremely unusual, but requires prompt treatment to avoid the potential complications of permanent functional impairment and limb loss.

Iatrogenic pseudoaneurysm of the superior gluteal artery presenting as pelvic mass with foot drop and sciatica: case report and review of literature.

We report an unusual case of a pseudoaneurysm of the superior gluteal artery as a complication of bone marrow biopsy. A 51-year-old man presented with sciatic pain and foot drop after undergoing bone marrow biopsy and was initially diagnosed as having degenerative disc disease based on his past medical history. Pelvic magnetic resonance imaging (MRI) revealed a large heterogeneous mass suggestive of a neurogenic tumor, but pulsatile blood was instead encountered during computed tomography (CT)-guided needle biopsy. Subsequent workup established the diagnosis of a superior gluteal artery pseudoaneurysm, which was treated with coil embolization, followed by surgical evacuation of the hematoma, which relieved his sciatic pain. However, the patient continues to have a persistent foot drop. Gluteal artery pseudoaneurysms are exceedingly uncommon but should be considered in the workup of a patient with gluteal pain or sciatic nerve palsy following trauma or medical procedures in the gluteal region.