A true giant aneurysm of the anterior tibial artery

Aneurysm of the anterior tibial artery as a complication of infectious endocarditis

OBJECTIVE

Mycotic aneurysms of the infrapopliteal vessels are rare, with few cases reported in the literature. Management strategies are diverse and should be tailored to the patient's presentation.

METHODS

We describe the case of a 40-year-old male who presented with a painful left leg mass in the setting of bacteremia and infective endocarditis. Imaging revealed an aneurysm of the anterior tibial artery.

RESULTS

The patient was treated with antibiotics and open surgical repair with excision of the aneurysmal sac, ligation of the anterior tibial artery, and primary repair of the popliteal artery and tibioperoneal trunk.

CONCLUSION

The epidemiology, pathophysiology, and clinical management of infrapopliteal aneurysms are briefly reviewed in this case study.

Urgent Endovascular Repair of an Anterior Tibial Artery Aneurysm: Case Report and Literature Review

True aneurysms of the anterior tibial artery are rare with less than 20 published reports in the literature. We report an urgent endovascular repair of a true anterior tibial artery aneurysm in a patient with Ehlers-Danlos type IV, vascular type. This approach resulted in an uneventful recovery without the elevated risks associated with open vascular repair in the setting of connective tissue disorder. Continuous follow-up in the subsequent 4 years has demonstrated durability and efficacy of the original intervention.

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.

Aneurysmectomy and Revascularization of Anterior Tibial Artery Aneurysm: Case Report

An 86-year-old man presented with a pulsatile mass in the anterior compartment of the right lower leg. He had become aware of it two months earlier. Computed tomography angiography revealed a fusiform 3.2×5 cm aneurysm of the anterior tibial artery. Mural thrombosis in the aneurysm was absent. Peripheral pulse was normal. We performed aneurysmectomy and revascularization using a saphenous vein graft. Histological findings revealed that the mass was a true aneurysm. The clinical course was good, and the graft has remained patent for six months.