Percutaneous angioplasty of the superior gluteal artery for buttock claudication: a report of seven cases and literature review

Abstract

Background: Buttock claudication due to stenosis or occlusion of the superior gluteal artery is infrequent. The recent development of noninvasive gluteal duplex scanning, combined with aortoiliac angiography using oblique projections and the availability of low-profile devices for percutaneous transluminal angioplasty (PTA), led us to review our recent experience concerning the diagnosis and mid-term results of PTA for superior gluteal artery stenosis or occlusion.

Methods: The files of all patients who had been treated in our department by PTA for superior gluteal artery stenosis or occlusion with buttock claudication were analyzed retrospectively, and any associated arterial lesions, morbidity, restenosis, or recurrent buttock claudication were noted. Outcomes were compared with published reports.

Results: Retrospective review identified six patients (5 men, 1 woman; mean age, 64 years) with seven cases of buttock claudication (1 bilateral localization) who had undergone PTA within the past 2 years. There was no case of isolated buttock claudication. Buttock claudication was associated with impotence, thigh claudication, or calf claudication in seven cases. Gluteal duplex scans were performed for three of the patients diagnosed with two stenoses and one occlusion. Aortoiliac angiography revealed five superior gluteal artery stenoses and two occlusions. PTA without stenting was successful in all cases, without morbidity or mortality. During a mean follow-up of 13 months, restenosis occurred in one patient. A repeat PTA without stenting was successful, with resolution of the buttock claudication.

Conclusions: Buttock claudication due to superior gluteal artery stenosis is probably underestimated when gluteal duplex scanning and aortoiliac angiography with oblique projections are not performed. PTA gives good results, and the procedure can be repeated should restenosis occur.