title: Recalcitrant peroneal artery pseudoaneurysm in a patient with Hemophilia B.
abstract: Pseudoaneurysms (PAs) of arteries in the lower extremities are uncommon. In most cases, a PA of the common femoral artery develops following percutaneous access and treatment with ultrasound guided thrombin injection achieves success rates approaching 98%. In contrast, the management of a PA of the distal leg vessels is more complex and may require additional endovascular and/or surgical treatments. We present a case of a recalcitrant PA involving the distal peroneal artery that developed following blunt trauma in a patient with Hemophilia B who failed ultrasound guided thrombin injection, para-aneurysmal saline injection and required two coil embolization procedures. Our observations suggest that Factor IX supplementation combined with aggressive coil embolization is the most effective treatment approach.
authors.affiliation: Division of Cardiovascular Medicine, University of Southern California, Los Angeles, CA, USA.
authors.forename: Ambarish
authors.initials: A
authors.lastname: Gopal
authors.forename: Nathan
authors.initials: N
authors.lastname: Aranson
authors.forename: Karen
authors.initials: K
authors.lastname: Woo
authors.forename: Leonardo
authors.initials: L
authors.lastname: Clavijo
authors.forename: David M
authors.initials: DM
authors.lastname: Shavelle
mesh_terms: D000328:Adult; D017541:Aneurysm, False / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000628:therapy*; D005164:Factor IX / Q000627:therapeutic use*; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D002836:Hemophilia B / Q000150:complications / Q000628:therapy*; D006801:Humans; D008297:Male; D013917:Thrombin / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000379:methods
chemical_list: D005164:Factor IX; D013917:Thrombin
keywords: Coil embolization; Hemophilia B; Pseudoaneurysm