A Rare Rescue Case of Post-biopsy Pseudoaneurysm Treated by Direct Percutaneous Glue Injection after Failed Embolization

Post-biopsy pseudoaneurysm is a rare but potentially life-threatening complication, particularly in hypervascular spinal lesions. We report a 67-year-old man with a hypervascular vertebral lesion in the right L2 transverse process who developed a retroperitoneal hematoma after computed tomography-guided biopsy. Initial transarterial embolization provided only temporary hemostasis. Due to technical constraints, including the presence of a spinal artery variant, repeat transcatheter arterial embolization was not feasible. Fluoroscopic computed tomography-guided direct injection of n-butyl cyanoacrylate-iodized oil into the lesion achieved definitive hemostasis. The patient remained stable without further transfusion. Histopathology confirmed solitary plasmacytoma. A follow-up computed tomography scan at 3 months demonstrated resolution of the hematoma without rebleeding. This case illustrates the utility of percutaneous n-butyl cyanoacrylate embolization as an effective rescue option in anatomically complex post-biopsy hemorrhage.