A case of popliteal pseudoaneurysm following vessel injury and subintimal application of paclitaxel-coated balloon

Paclitaxel-coated balloon (PCB) is a commonly used endovascular device for symptomatic patients with a femoropopliteal lesion. However, pseudoaneurysm is a rarely encountered complication after PCB treatment. PCB treatment for right popliteal arterial occlusion was performed on a 67-year-old female. Three months later, a right popliteal pseudoaneurysm was detected and a covered stent was implanted. The mechanism of pseudoaneurysm, indicated by the serial assessment of angiography and intravascular ultrasound during these endovascular treatments, was arterial wall injury, subintimal passage of wires, subintimal PCB attachment, and arterial dilation after PCB treatment. Our case suggested that the subintimal PCB application after arterial wall injury may have a risk of pseudoaneurysm after the PCB treatment.