Successful endovascular treatment of a ruptured gigantic pseudoaneurysm of the common iliac artery secondarily complicated by infection.

We report our experience with a case of emergent endovascular treatment of a large ruptured pseudoaneurysm of the common iliac artery. A 65-year-old male was admitted to the surgical department in hypovolemic shock, due to active retroperitoneal bleeding. A computerized tomography scan with intravenous contrast revealed a ruptured gigantic pseudoaneurysm of the right common iliac artery, with a maximal diameter of 7 cm and retroperitoneal hematoma. An intraoperative angiogram revealed active extravasation through the neck of the pseudoaneurysm, which was successfully sealed with the placement of a stent graft (Medtronic Endurant(®))limb component. Infection of the pseudoaneurysm sac after one month was successfully treated with catheter drainage. No shortterm relapse occurred. Endovascular management should be part of the basic surgical armamentarium on emergent basis, since it provides a fast and safe solution, especially when a patient's co-morbitities preclude open management and hemodynamic and anatomical status allows endovascular treatment.