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A 30-year-old woman with a complex postpartum course underwent emergent catheter angiography confirming pseudoaneurysm with extravasation. LAVA Liquid Embolic System was injected through a microcatheter to fill the pseudoaneurysm and its inflow/outflow. Post-embolization angiography showed complete occlusion while preserving gluteal muscle perfusion, and the patient was discharged the next day. The report also reviews device composition and practical advantages over other liquid embolics, noting the need for further studies.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/embolization-of-gluteal-pseudoaneurysm-using-the-lava-liquid-embolic-system-letter-to-the-editor/460460/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/embolization-of-gluteal-pseudoaneurysm-using-the-lava-liquid-embolic-system-letter-to-the-editor/460460.png","ImageObject",300,407,{"name":92,"@type":93},"moss~","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-07","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":81},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What triggered the gluteal pseudoaneurysm in this case?","Question",{"text":112,"@type":113},"Bleeding from the drain insertion site occurred after removal of a transgluteal drain, suggesting a vascular injury being tamponaded by the drain.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How was the pseudoaneurysm treated using the LAVA liquid embolic system?",{"text":117,"@type":113},"After emergent catheter angiography confirmed extravasation, LAVA was slowly injected through a microcatheter to fill the pseudoaneurysm, inflow branch, and distal outflow.",{"name":119,"@type":110,"acceptedAnswer":120},"What was the immediate result after embolization?",{"text":121,"@type":113},"Postembolization angiography demonstrated successful occlusion of the pseudoaneurysm with preserved perfusion of the gluteal muscle, and the patient was discharged the following day.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},460460,1790758519,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":81,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":14,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":129,"read_time":24,"preview_page_count":4},962090895452,"https://ap-avatar.wpscdn.com/davatar_a8503ba1806abce46bf441b54a3ca4cd","Article published online: 2025-06-24  \nLetter to the Editor 147  \nEmbolization of Gluteal Pseudoaneurysm Using the LAVA Liquid Embolic System  \nMili Rohilla 1 Samruddhi Jain2 Vibhor Wadhwa3  \n1 Department of R3 Diagnostic Radiology, St. Vincent Hospital, Worcester, Massachusetts, United States  \n2 Department of R2 Diagnostic Radiology, St. Vincent Hospital, Worcester, Massachusetts, United States  \n3 Division of Interventional Radiology, Southern New Hampshire Radiology Consultants, Elliot Hospital, Manchester, New Hampshire, USA  \nIndian J Radiol Imaging 2026;36:147–148.  \nThe LAVA Liquid Embolic System (LES) (BlackSwan Vascular, Inc.) received Food and Drug Administration approval in October 2023 for use in patients with peripheral vascular hemorrhage.1 Given its recent approval, limited published literature exists on its clinical use. The authors report using this embolic to successfully treat a gluteal pseudoaneurysm secondary to percutaneous transgluteal drain placement.  \nA 30-year-old female with a complex postpartum history—comprising postpartum hemorrhage requiring uterine artery embolization, endometritis, and a deep pelvic abscess requiring transgluteal drain placement—presented for routine drain removal. Following the removal of the drain, the patient experienced significant bleeding from the drain insertion site, suggesting a vascular injury that was being tamponaded by the drain. Computed tomography angiography of the pelvis revealed apseudoaneurysm in the left gluteus maximus along the removed transgluteal drain tract ( ►Fig. 1). Emergent catheter angiography of the left superior gluteal artery confirmed apseudoaneurysm with extravasation ( ►Figs. 2 and 3). A 2.4FProgreat(Terumo Interventional Systems)microcatheter with anondetachable tip was primed with 0.5mL dimethyl sulfoxide (DMSO), and 0.2mL LAVA 34 was slowly injected, filling the pseudoaneurysm, inflow branch, and distal outflow. Postembolization angiography showed successful occlusion with preserved gluteal muscle perfusion ( ►Fig. 4). The patient was discharged the following day.  \nThe LAVA LES is approved for peripheral vascular hemorrhage and is an injectable, nonadhesive liquid embolic agent composed of ethylene vinyl alcohol (EVOH) copolymer dissolved in DMSO with suspended micronized tantalum powder. As DMSO dissipates into the blood, EVOH precipitates,  \narticle published online June 24, 2025  \nDOI [https://doi.org/](https://doi.org/)[ ](https://doi.org/)10.1055/s-0045-1809413 . ISSN 0971-3026.  \nAddress for correspondence Vibhor Wadhwa, MD, Division of Interventional Radiology, Southern New Hampshire Radiology Consultants, Elliot Hospital, 1 Elliot Way, Manchester, NH 03103, United States (e-mail: [vibhorwadhwa90@gmail.com](vibhorwadhwa90@gmail.com)).  \nforming a spongy, coherent embolus, while tantalum remains in place for fluoroscopic visualization.  \nLAVA LES was selected for this case due to its controlled, cohesive flow, allowing deep arterial penetration while preventing backflow into the pseudoaneurysm via collaterals. Specifically designed for peripheral circulation, it is optimized for viscosity, radiopacity, and vial volume to enhance procedural precision and effectiveness.2 Unlike traditional liquid embolic agents like glue (n-butyl cyanoacrylate, Johnson & Johnson) or Onyx LES (Medtronic), typically supplied in 1mL vials, the LAVA comes in larger vials, up to 6mL, making it better suited for peripheral interventions where larger volumes are often needed. LAVA LES offers advantages over other  \nFig. 1 Axial computed tomography angiography (CTA) of the pelvis immediately after drain removal demonstrating pseudoaneurysm (arrow) within the left gluteal region along the transgluteal drain tract.  \n© 2025 . Indian Radiological Association. All rights reserved.  \nThis is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the","cbCail4LIXxmXiih","https://ap.wps.com/l/cbCail4LIXxmXiih","pdf",737302,"English","# Case description\n## Presentation and imaging\n## Embolization procedure with LAVA\n## Outcome and discharge\n# Rationale and comparison with other embolic agents\n## Mechanism and composition of LAVA LES\n## Injection characteristics and vial volume\n## Reported safety and complications vs alternatives\n## Need for further research","[{\"question\":\"What triggered the gluteal pseudoaneurysm in this case?\",\"answer\":\"Bleeding from the drain insertion site occurred after removal of a transgluteal drain, suggesting a vascular injury being tamponaded by the drain.\"},{\"question\":\"How was the pseudoaneurysm treated using the LAVA liquid embolic system?\",\"answer\":\"After emergent catheter angiography confirmed extravasation, LAVA was slowly injected through a microcatheter to fill the pseudoaneurysm, inflow branch, and distal outflow.\"},{\"question\":\"What was the immediate result after embolization?\",\"answer\":\"Postembolization angiography demonstrated successful occlusion of the pseudoaneurysm with preserved perfusion of the gluteal muscle, and the patient was discharged the following day.\"}]","Embolization of Gluteal Pseudoaneurysm Using the LAVA Liquid Embolic System - Letter to the Editor | PDF"]