American Journal of Roentgenology, Vol 170, 349-353, Copyright © 1998 by American Roentgen Ray Society
Endovascular management of bleeding iliac artery pseudoaneurysms complicating radiation therapy for pelvic malignancies
T de Baere, A Ousehal, V Kuoch, M Sapoval, C Lagrange and A Roche
Department of Interventional Radiology, Gustave Roussy Institute, Villejuif, France.
OBJECTIVE: We evaluated arteriographic findings and endovascular treatments
of eight patients who had bleeding iliac artery pseudoaneurysms and who had
undergone radiation therapy (3000-6500 rad [30-65 Gy]) and surgery for
pelvic malignancies. CONCLUSION: Angiography revealed contrast media
extravasation in 75% of patients who had bleeding iliac artery
pseudoaneurysms and failed to show the source of bleeding in 25%. The
patients who had positive findings at angiography were all successfully
treated percutaneously, although two patients required additional bypass
surgery. Among embolic materials, coils and balloons were safe and
efficient, whereas cyanoacrylate was unsafe and led to complications in two
of three patients. A covered stent, which was not available for most of our
patients, was used in one patient and may be an effective means of treating
pseudoaneurysms.
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