This is a case of a 63 year-old male with a history of atrial fibrillation that is taking Warfarin medication.

The patient has suffered left pelvic pain for 5 days. There was a suspicion of diverticulitis.

He underwent a CT scan at another hospital, which revealed a ruptured left hypogastric aneurysm with a large retroperitoneal hematoma. The patient was then transferred to Aker University Hospital for intervention.

The CT volume has been imported on the Advantage Workstation Volume Share 2 and postprocessed (see Fig.1 and Fig.2).

After catheter placement using low dose fluoroscopy, a Digital Subtraction Angiography (DSA) acquisition was performed with an injection of 8cc of Visipaque (GE) - 270mgI/mL (see Fig.3).

An Innova 3D acquisition was performed at 40°/s, taking 5 seconds with an injection of 40cc of Visipaque(GE) - 270mgI/mL at 8cc/s.This was done before the treatment (see Fig.4).The injection point was on the aorta and the XRay acquisition is delayed by 1.5 seconds.

After the dilatation, a further Innova 3D acquisition was performed at 40°/s, taking 5 seconds, with an injection of 40cc of Visipaque(GE) - 270mgI/mL at 8cc/s. This was done after the treatment (see Fig.9). The injection was on the aorta and the X-Ray acquisition is delayed by 1.5 seconds.

In this case, an endovascular repair of the ruptured aneurysm was possible, making open vascular surgery unnecessary. The high quality images obtained on the system, made both the planning and performance of the procedure easy.

The Innova CT acquisition mode is useful to evaluate retroperitoneal hematomas avoiding transport of the patient to a conventional CT Scanner. We will use this application - especially in cases involving the rupture of iliac arteries during PTA/stent for atherosclerotic obliterative disease.