PMC9257338_01
Computed tomography angiography (CTA) evolution (axial and coronal views). Admission CTA: six mm diameter, 6 mm depth terminal aorta and proximal left common iliac artery posterolateral wall ulceration. Three month CTA demonstrated arterial wall defect stability. Asymptomatic evolution to a 40 mm pseudoaneurysm detected on six month CTA. Magnetic resonance imaging documenting apparent arterial wall ulcer (dotted circle) related to psoas collection (*).
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At this arterial level six mm diameter, 6 mm depth wall ulceration was visible (Fig. 1). However, the six month CTA (Fig. 1) revealed ulceration evolution to a 40 mm pseudoaneurysm.
Magnetic resonance imaging documenting apparent arterial wall ulcer (dotted circle) in relation to psoas collection (*).
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Magnetic resonance imaging ruled out spondylodiscitis but documented the arterial wall involvement (Fig. 2).
Intra-operative findings and arterial reconstruction. After pseudoaneurysm excision, complete disruption of the terminal aorta and proximal left common iliac artery (LCIA) posterolateral wall was visible (A, dotted line circle). Aorto-bi-iliac interposition graft, after extensive infected tissues debridement (B).
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Intra-operatively the pseudoaneurysm was excised revealing complete disruption of the terminal aorta and proximal left common iliac posterolateral wall (Fig. 3A). An aorto-bi-iliac interposition graft was performed (16 x 8 mm silver acetate/triclosan collagen coated polyester graft Intergard Synergy  Getinge ) (Fig. 3B).