A long-standing external iliac artery pseudoaneurysm in a patient with a history of a failed kidney transplant

This is a case of a 66-year-old African American male with history of end stage renal disease due to polycystic disease and failed right kidney transplant. He presents with asymptomatic hematuria, and diagnostic angiography was performed which showed incidental anastomotic site pseudoaneurysm. Our patient had an unusual presentation of a pseudoaneurysm. Pseudoaneurysms associated with failed renal transplants are typically detected within weeks after transplantation and along with failure of the transplant. Our patient's anastomotic site pseudoaneurysm was detected 21 years after transplantation and 15 years after transplant failure. Rupture of a pseudoaneurysm can occur at anytime and treating it with a covered stent is a feasible option.