ArticleJACC. Case reports2026
A Rare Large-Artery Complication of Cryoglobulinemia: Superior Gluteal Artery Pseudoaneurysm.
Article in JACC. Case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundCryoglobulinemia is an immune complex-mediated vasculitis that predominantly affects small and medium-sized vessels. Involvement of large arteries is exceedingly rare, and pseudoaneurysm formation has rarely been described. CASE SUMMARY: A 44-year-old man with hepatitis C-negative cryoglobulinemic vasculitis and a mechanical aortic valve on chronic anticoagulation presented with acute left gluteal pain, near syncope, and severe anemia. Computed tomography angiography revealed a large left gluteal hematoma with active arterial extravasation. Digital subtraction angiography demonstrated a markedly enlarged superior gluteal artery supplying a large pseudoaneurysm. Distal-to-proximal endovascular embolization resulted in complete exclusion of the pseudoaneurysm and hemodynamic stabilization. DISCUSSION: This case illustrates an exceptionally rare large-artery complication of cryoglobulinemia, highlighting the potential for immune-mediated vascular injury to extend beyond the small- and medium-vessel circulation. The deep anatomic location of the superior gluteal artery can obscure early diagnosis, and delayed recognition may result in life-threatening hemorrhage.
conclusionsClinicians should consider vasculitic etiologies, including cryoglobulinemia, in patients presenting with spontaneous pseudoaneurysm formation and acute hemorrhage in the absence of trauma. Early recognition and endovascular intervention can be lifesaving.
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