Management of iatrogenic superior gluteal artery injury post-bone marrow biopsy: A case report of successful endovascular balloon occlusion

Iatrogenic vascular injury, particularly to the superior gluteal artery (SGA), though rare, represents a critical complication of bone marrow biopsy due to the artery's anatomical vulnerability during the procedure. This vulnerability can lead to life-threatening hemorrhage, retroperitoneal or gluteal hematomas, pseudoaneurysms, or compartment syndrome. The SGA's anatomy, which is not easily accessible via open surgery, makes endovascular therapy the preferred intervention. Temporary balloon occlusion is 1 endovascular option; it preserves collateral circulation, unlike permanent coils or stents, which carry risks of thrombosis or stenosis. Published literature supports endovascular approaches, demonstrating high success rates with fewer complications despite technical complexity. We report a case of a 41-year-old male with precursor B-cell lymphoblastic leukemia who sustained a rare SGA injury during a routine bone marrow biopsy at the posterior superior iliac crest and was successfully managed endovascularly.