Massive bleeding embolization of the right calf

Baseline Central

A 90-year old woman came to our attention after a blunt trauma and subsequent hematoma in the right calf. The hematoma caused diastasis of the soft tissues of the leg with external bleeding.

The woman with a hemoglobin of 5mg/dl was carried to our angiography suite without further imaging. Diagnostic angiography confirmed a massive bleeding in the right calf.

First Embolization

Using a Bern-shape Direxion™ torquable microcatheter and a Fathom 0.016" (0.406mm) micro-guidewire we were able to advance distally through  a vessel arising from the middle third of the popliteal artery and to embolize it with two 3x2mm microcoils until the complete closure of this branch.

Every feeding vessel

The subsequent angiography showed complete embolization of the treated  vessel but some small branches were still supplying the bleeding.

Using the same microcatheter we were easily able to catheterize three small vessels arising from the peroneal artery. One was embolized with a 3x2  mm coil and the other two with PVA.


The final angiographic scan performed through the proximal popliteal artery showed complete closure of the treated vessels without evidence of further bleeding and complete patency of the anterior tibial and peroneal artery. The posterior tibial artery was already closed at the first diagnostic angiogram.
Study and images courtesy of
Dr. Rita Golfieri – Chief of Radiology Unit and Vice Director of Department of Digestive Disease – Sant’Orsola Malpighi Hospital - Bologna
Dr. Francesco Modestino – Interventional Radiologist – Sant’Orsola Malpighi Hospital - Bologna