Brief Reports
Embolization of Profunda Femoris Artery Branch Pseudoaneurysms with Ethylene Vinyl Alcohol Copolymer (Onyx)

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This report describes the use of a new embolic agent, Onyx, which is composed of ethylene vinyl alcohol copolymer dissolved in 8% dimethyl sulfoxide, in the endovascular transcatheter embolization of traumatic profunda femoris artery branch pseudoaneurysms in three cases. Two of the cases involved massive thigh swelling after penetrating injury and the other involved massive hemorrhage at the site of a surgical fixator pin. Diagnostic angiography revealed pseudoaneurysm formation of the profunda femoris artery branches in all cases. Immediate control angiography after the embolization procedures demonstrated complete closure of the pseudoaneurysms. During the follow-up period there was no recurrent bleeding. The advantages of Onyx over conventional liquid embolic agents and coils are discussed.

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Case 1

A 36-year-old man had an open right femur fracture after a traffic accident 8 years earlier. Since that time, he had been surgically treated several times for malunion, osteomyelitis, and pseudoarthrosis. Two weeks before admission to our clinic, he had undergone surgery by an orthopedic surgeon who used external fixators to stabilize the thigh. Two days after the operation, massive hemorrhage occurred at the site of the proximal external fixator pin. External compressive bandages could only

DISCUSSION

Pseudoaneurysms develop as a result of inflammation, trauma, neoplasm, or surgical procedures, and originate from a disruption of arterial continuity with extravasation of blood into the surrounding tissue, where a fibrous tissue capsule is formed (5). Also, a pseudoaneurysm may have variable amounts of the media and adventitia as part of their wall. Traumatic arterial injuries can result in serious early and delayed complications, months or even years after the injury. Patients with

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