Tibioperoneal trunk pseudoaneurysm coil embolization

Resection of Giant Mycotic Aneurysm in the Tibioperoneal Trunk by Posterior Approach in a Prone Position with Air Tourniquet

Aneurysms of the tibioperoneal trunk (TPT) with peripheral arterial lesions are extremely rare. We present a case of a 68-year-old man who underwent surgical treatment for a mycotic aneurysm of the TPT. This report highlights the importance of en bloc surgical resection of the mycotic aneurysm and an appropriate approach with an air tourniquet for the prevention of injuries to the adherent tissues.

Successful endovascular isolation of a huge true anterior tibial artery aneurysm by the bi-directional approach in a young patient

Anterior tibial artery aneurysms (ATAAs) are relatively rare entities. Most ATAAs are pseudoaneurysms resulting from trauma, infection, or iatrogenic injury. We observed a 33-year-old woman with a huge true ATAA who did not have any potential cause of pseudoaneurysm or risk factors for atherosclerosis or connective tissue disorder. Endovascular isolation by the bi-directional approach was successfully performed, and the ATAA was totally excluded from the afferent blood flow. Distal flow of the anterior tibial artery was preserved, and pulsation of the dorsal pedis artery was also well preserved. Her postoperative course was uneventful, and follow-up ultrasonography and magnetic resonance imaging revealed the ATAA shrinkage.

Tibioperoneal Trunk Aneurysm Resulting in Compartment Syndrome with Associated Aneurysms of the Popliteal and Dorsalis Pedis Arteries

True aneurysms of the tibioperoneal trunk are rare. Given the scarcity of reports, the clinical presentation and treatment is not well defined. This is a case report of a 50-year-old male patient presenting with severe lower extremity swelling and compartment syndrome with neurological compromise secondary to a tibioperoneal trunk aneurysm. He was also noted to have discrete ipsilateral popliteal and dorsalis pedis artery aneurysms. Given the location and size of the aneurysm, the severe leg swelling, and venous hypertension, aneurysmorrhaphy or aneurysm sac excision with arterial reconstruction was prohibitively dangerous. Thus, following fasciotomies, a hybrid repair utilizing a saphenous vein superficial femoral to anterior tibial artery bypass along with coil embolization of the aneurysm sac was performed. The patient recovered full function of his leg and follow-up computed tomography angiogram demonstrated thrombosis and regression of the aneurysm sac with a patent bypass.

Spontaneous tibioperoneal trunk and anterior tibial artery pseudoaneurysms

Aneurysms of the tibioperoneal trunk and anterior tibial artery are extremely rare. There are only a few case reports of this entity, for which the majority are secondary to prior trauma or bacteremia and endocarditis. We describe a case of spontaneous pseudoaneurysms of the right anterior tibial artery and tibioperoneal trunk. The pseudoaneurysms were thrombosed on follow-up computed tomography angiography and the patient has been asymptomatic. The patient is being treated conservatively and remains asymptomatic at 1 year of follow-up.