Pseudoaneurysm following ankle arthroscopy: a systematic review of case series

Spontaneous pseudoaneurysm of the posterior tibial artery successfully treated by open surgery: Case report and review of the literature

RATIONALE

An extremely rare spontaneous pseudoaneurysm (PSA) of the posterior tibial artery (PTA) in a middle-aged male patient was cured by open surgery effectively.

PATIENT CONCERNS

A 53-year-old man presented with the increasing swollen left shank for 1 day, with intermittent pain, pulselessness and pallor. He denied the history of trauma, infection, and other diseases.

DIAGNOSES

Physical examination, past medical history, ankle brachial index, ultrasonography, computed tomographic angiography (CTA), 3-dimensional reconstruction image of the popliteal artery and its branches and histological examination of intraluminal thrombus and clots helped us diagnose the patient as spontaneous PSA of PTA.

INTERVENTIONS

Our patient underwent excision of PSA and repair operation of PSA.

OUTCOMES

The patient recovered well at 2-year follow-up.

LESSONS

This rare case provides valuable insights for tissue repair and vascular surgery. Therapeutic methods should be in accordance with the best interest of patient. Open surgery is the effective treatment for spontaneous PSA of PTA.

Open repair of a plantar artery pseudoaneurysm after Morton's neurectomy

A 65-year-old woman presented to our institution with 4 months of severe pain on the plantar aspect of her foot. She had chronic foot pain secondary to Morton's neuroma and had recently undergone neurectomy. She was found to have a large pseudoaneurysm on the plantar aspect of her foot. She was taken to the operating room for an open repair from a plantar approach. We obtained the patient's consent to publish this case.

Usefulness of doppler techniques in the diagnosis of peripheral iatrogenic pseudoaneurysms secondary to minimally invasive interventional and surgical procedures: imaging findings and diagnostic performance study

The pseudoaneurysm (PA) is a perfused sac directly connecting with the arterial lumen by an interruption of the vessel wall continuity, more commonly secondary to trauma or iatrogenic causes. Aim of our study was to determine the accuracy and usefulness of Doppler techniques in the diagnosis of peripheral iatrogenic PAs secondary to minimally invasive procedures. From a three year prospective research, 20 Duplex Ultrasound (DUS) studies in as many patients presenting with periarterial pulsating mass clinically suspected for PA secondary to minimally invasive procedures were selected. The PA final diagnosis was confirmed by angiography in 12 patients (60% cases), by computed tomography angiography in 5 patients (25%), by surgery in 2 patients (10%), and by magnetic resonance angiography in 1 patient (5%). The vessels involved by PA formation were: common femoral artery in 8 cases (40%); superficial femoral artery in 4 cases (20%); brachial artery in 3 cases (15%); popliteal artery in 2 cases (10%); superficial temporal artery (STA) in 2 cases (10%); dorsal medial digital artery of the foot in 1 case (5%). Our study confirmed the usefulness of doppler techniques in the diagnosis of peripheral iatrogenic PAs. Specifically, a sensitivity of 90-95%, a specificity of 100% and predictive values of 100% (VPP) and 83-90% (VPN) were reported. The radiologist must always suspect a PA in the differential diagnosis of lesions contiguous to an artery vessel. This is to prevent potential complications such as e.g. massive haemorrhage. In this order, DUS allows a careful selection of patients who require to undergo in-depth imaging methods or surgical therapy, thus contributing to a significant reduction of contrast medium and exposure to ionizing radiation.