Dorsalis pedis artery true aneurysm due to atherosclerosis: Case report and literature review

Open surgical repair of true saccular aneurysm of dorsalis pedis artery using a reversed great saphenous vein bypass graft

True aneurysms of the dorsalis pedis artery (DPA) are very rare phenomena with no obvious pathophysiology. Prompt diagnosis and treatment are important due to the high risk of thrombosis, distal embolization, hemorrhage, and rupture. We present a case of a true DPA saccular aneurysm in a 58-year-old man and highlight the feasibility of using a reversed great saphenous vein bypass graft in specifically treating true DPA aneurysms. Our treatment resulted in near-immediate resolution of the patient's foot pain and mass without complications and maintaining arterial patency.

Traumatic pseudo-aneurysm in a 5-year-old child, case report and literature review

INTRODUCTION

Pseudo-aneurysm can be formed by iatrogenic factors, as well as non-iatrogenic factors. In the pediatric population, there have only been a few recorded incidences. The work has been reported in line with the SCARE criteria.

CASE PRESENTATION

In our case, a five-year-old male who was medically free presented with a complaint of left foot swelling after a one-month history of glass trauma and two episodes of bleeding. Upon presentation to our facility, an examination of the left foot's dorsum revealed a 2.0 ∗ 2.0 cm pulsatile non-tender swelling with no symptoms of infection, and a healed scar. A lower limb arterial doppler ultrasonography was performed, and it revealed a 1 cm partially thrombosed pseudoaneurysm protruding from the Dorsalis Pedis Artery (DPA).

CLINICAL DISCUSSION

Lower extremity peripheral aneurysms, whether true aneurysm or a pseudo-aneurysm, are uncommon in adults and usually occur in the popliteal artery (70 %), femoral artery (20 %), and only (10 %) of aneurysms present in other locations (Dahman et al., 2021). This Condition is even extremely unusual in pediatric population, where only a few cases have been reported. Doppler ultrasonography was used as a radiological examination and a diagnostic approach in the case of our patient. Due to the rarity of this illness, there are no clear guidelines for approaching patients with similar symptoms.

CONCLUSION

A dorsalis pedis pseudoaneurysm should be considered in any traumatic injury that has resulted in a hematoma in the dorsum of the foot that is not healing. In our case, a primary aneurysm excision with DPA ligation appears to be a safe procedure with no effect on foot perfusion or function.

True Aneurysms of Foot Arteries: A Case Report of a Young Patient

BACKGROUND

Reports of true aneurysms of the lower leg are rare. Among them, cases involving young patients are all the more rare, and there are many unexplored aspects to this pathological condition.

CASE PRESENTATION

This is a case of a 30-year-old woman who was referred by an orthopedic surgeon with a chief complaint of severe pain during walking and landing. Angiography revealed multiple aneurysms and arteriovenous fistulas in the posterior tibial artery and lateral plantar artery. We anastomosed the lateral plantar artery and interposed the posterior tibial artery using the great saphenous vein.

CONCLUSIONS

Although aneurysms in the arteries of the feet are rare, multiple true arterial aneurysms were observed in the lower leg of a juvenile patient in the present case. Dilation of arteries other than the aneurysm was also observed, suggesting that arteriovenous fistula and arterial occlusion may have been the causes of the true aneurysm of the lower leg. This is a valuable finding, suggesting a cause of aneurysm other than age-related atherosclerotic changes.

Dorsalis pedis artery aneurysm

Aneurysm of the pedal arteries is uncommon. Dorsalis pedis aneurysms are a clinically rare phenomenon. We present a case of traumatic fusiform aneurysm of the dorsalis pedis artery in an otherwise well 53-year-old Caucasian man. Initial history was suggestive of micro-embolic disease to the medial toes of the left foot and on examination pulses were palpable throughout the lower limbs with a strong, palpable dorasalis pedis pulse. Ankle brachial pressure indexes were normal but reduced toe pressures to the left toes. Colour flow duplex imaging revealed aneurysmal dilation, involving all layers of artery wall, with irregular intraluminal thrombus across a 16-mm segment. Subsequent CTA run-off revealed all vessels were patent in the left lower limb. Due to concerns over further embolisation, our patient underwent successful ligation of the his dorsalis pedis. He had an uneventful post-operative recovery.

True dorsalis pedis artery aneurysm: case report

A true aneurysm of the dorsal artery of the foot is a rare medical finding and its principal causes and clinical manifestations are not well known. A 49-year-old female patient presented with a pulsatile mass on the dorsal part of her right foot. Clinical and ultrasound examinations confirmed a diagnosis of aneurysm. The aneurysm was resected after dissection, exposure and isolation of the proximal and distal stumps of the dorsalis pedis artery. Simple ligature and resection of the aneurysm is proving to be a safe treatment option in patients with a patent plantar arch.

Exploring the Molecular Mechanism of Thoracic Aortic Aneurysm via Bioinformatics Analysis

BACKGROUND The aim of this study was to identify some key genes related to the pathogenesis of thoracic aortic aneurysm (TAA) and gain more insights to the molecular mechanism of TAA. MATERIAL AND METHODS The expression profile of GSE9106 was downloaded from the Gene Expression Omnibus (GEO) database. The data contained 58 TAA peripheral blood samples and 36 normal peripheral blood samples. The differently expressed genes (DEGs) between the TAA samples and the normal samples were identified via limma package of R. Functional enrichment analysis of the DEGs were performed via the Database for Annotation, Visualization and Integrated Discovery (DAVID). The differentially co-expressed genes in TAA samples compared to normal samples were identified via the DCGL package in R. The protein-protein interaction (PPI) network of the DEGs was constructed through the Search Tool for the Retrieval of Interacting Proteins (STARING) database and visualized by Cytoscape software. RESULTS A total of 407 DEGs were obtained in TAA samples compared with normal samples. The DEGs were enriched in 29 Gene Ontology (GO) terms. There were 1,441 co-expression gene pairs that had significant changes in the co-expression status in TAA samples compared with normal samples and a differential co-expression network was constructed based on them. Moreover, a PPI network of the DEGs was constructed, containing 101 nodes. CONCLUSIONS Bioinformatics methods could identify significant biological processes and genes related to TAA. KRTDAP, BICD1, and genes in the OR family might play an important role in TAA.

True Aneurysm of the Dorsal Artery of the Foot: Case Report and Review of the Literature

True aneurysm of the dorsal artery of the foot is extremely rare, and its clinical manifestations are little known. A case of a true dorsalis pedis artery aneurysm in a 51-year-old man, with no history of local trauma or injury on his foot, is presented. Clinical examination and ultrasonic imaging confirmed the aneurysm. Dorsalis pedis artery aneurysm after this had been exposed, the proximal and distal stumps of the dorsal artery of the foot were isolated and ligated, and the aneurysm was resected.

A True Posterior Tibial Artery Aneurysm

Aneurysms of infrapopliteal arteries are rare. The etiology is usually traumatic, and most aneurysms are false. The English-language literature reports only 33 cases of infrapopliteal arterial true aneurysms, of which 8 involve the posterior tibial artery. The etiology of these lesions is unclear; a fibromuscular fibrodysplasia similar to ulnar aneurysm may be hypothesized, but traumatic, atherosclerotic, inflammatory, and other pathological processes are also probably involved. The natural history seems to be related to thrombosis and distal embolism more than to rupture. Surgical indications are debated. Aneurysm repair with a complete restoration of the blood flow through the affected artery is particularly challenging owing to the small size of the vessels, and ligation may be required. We report, to the best of our knowledge, the first case of an atherosclerotic posterior tibial artery true aneurysm successfully treated with aneurysmectomy and end-to-end direct reconstruction with a documented good long-term patency. Clinical features, imaging findings, and surgical management are described; indications and treatments (open or endovascular) are discussed.

Nontraumatic Aneurysms Affecting Crural Arteries: Case Report and Review of the Literature

Aneurysms involving the infrapopliteal arteries are rare, with most cases being attributed to a previous traumatic event. Mycotic aneurysms in this location are even more uncommon. Owing to their infrequency, these aneurysms represent a difficult diagnostic challenge. We present a case of a symptomatic anterior tibial artery aneurysm in a 59-year-old male with a medical history significant only for an episode of bacterial endocarditis, subsequently requiring an aortic valve replacement. Surgical repair was performed with a popliteal to anterior tibial bypass with a reversed saphenous vein graft. The patient's recovery was uneventful. We also reviewed the literature on this type of aneurysm to assess the incidence, etiology, options for treatment, and outcomes.

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.

"Sandal strap" trauma and atherosclerosis are dual pathologies leading to bilateral true aneurysms of the dorsalis pedis arteries

True aneurysm of the dorsalis pedis artery is rare. To our best knowledge, only 19 cases have been reported in the literature with one case of bilateral involvement. We describe an unusual case of simultaneous, bilateral true aneurysms of the dorsalis pedis arteries due to chronic mild trauma from dorsally positioned sandal straps with secondary atherosclerotic change. This is the first such case reported. Symptomatic aneurysms are at risk for thrombosis or embolization, and surgical management is recommended. In our case, both aneurysms were resected and repaired with interposition graft of saphenous vein. The patient was symptom free at 6-month follow-up.

Repair of bilateral true aneurysms of the dorsalis pedis artery

Aneurysms of peripheral arteries are infrequent, with an incidence <1%. Dorsalis pedis artery (DPA) aneurysms are extremely rare, and most of them are pseudoaneurysms secondary to trauma or iatrogenic injuries. We report the first case of simultaneous (synchronous) bilateral DPA true aneurysms and how we repaired them. We review the literature on DPA true aneurysms and focus on the surgical management.

Repair of a true dorsalis pedis artery saccular aneurysm

Aneurysms of the foot arteries are rare. A case of a true dorsalis pedis artery saccular aneurysm in a 60 years old man in which there was no history of trauma is presented. The arterial duplex, intraoperative features, operative procedure and literature review are presented and discussed.

Giant, metachronous bilateral dorsalis pedis artery true aneurysms

This report is the first to describe the clinical, radiographic, operative, and pathologic findings associated with large, bilateral dorsalis pedis artery true aneurysms in a single patient. A 61-year-old African American woman complained of difficulty in wearing shoes. She had a moderately firm, nontender, pulsatile mass on the dorsum of her right foot. Computed tomography and angiography confirmed dorsalis pedis artery aneurysm with sufficient collateralization. She underwent resection without reconstruction. Pathologic analysis revealed a true aneurysm (8 × 5.3 × 4.1 cm(3)) containing intralumenal thrombus. Treatment for small symptomatic and large dorsalis pedis artery aneurysms remains resection with or without reconstruction.

Endovascular treatment of abdominal aortic aneurysms combined with bilateral common and internal iliac aneurysms

INTRODUCTION

Combined aneurysms of aortic and iliac arteries are rare with a prevalence of less than 0.1%. However, these combined aneurysms are associated with a high incidence of thrombosis, distal embolism, or rupture. Endovascular repair is a therapeutic option and includes embolization of the internal iliac artery in numerous cases. Embolization of the internal iliac artery may cause severe ischemia with hip and buttock complications in 2-5%. Therefore, preservation of internal iliac arteries is essential to reduce complications.

PATIENT AND METHOD

We describe in detail an endovascular procedure for combined abdominal aortic (diameter of 8.6 cm) and bilateral common and internal iliac aneurysm (diameter of the left side: 6.4 cm; diameter of the right side: 4.3 cm) in a 44-year-old patient caused by media necrosis Erdheim-Gsell. The blood flow of both internal arteries was preserved in this patient.

RESULT

Operation was done without any complications. Conversion to an open procedure was not necessary. During follow up (3, 6, and 12 months after operation) the patient did not develop any signs of severe hip and buttock complications. Furthermore, sonography and CT angiography revealed a good blood flow via the internal and external iliac arteries.

CONCLUSION

Endovascular repair of abdominal aortic aneurysms combined with bilateral common and internal iliac aneurysms offers a promising minimal invasive procedure. Most importantly, this technique is less invasive than open operations and reduces complications by preserving the pelvic perfusion.

The relationship between the deep fibular nerve and the dorsalis pedis artery and its surgical importance

The aim of this study was to demonstrate the relationship between the deep fibular nerve and the dorsalis pedis artery to provide useful anatomical knowledge for safe surgical approaches in plastic surgery. The dissection of 30 cadaver lower limbs was undertaken to describe the relationship of the deep fibular nerve to the dorsalis pedis artery in the anterior tarsal tunnel and on the dorsum of the foot. The anterior tarsal tunnel is a flattened space between the inferior extensor retinaculum and the fascia overlying the talus and navicular. The deep fibular nerve and its branches pass longitudinally through this fibro-osseous tunnel, deep to the tendons of the extensor hallucis longus and extensor digitorum longus. Four distinct relationships of the deep fibular nerve to the dorsalis pedis artery were determined. The dorsalis pedis neurovascular island flap contains both the dorsalis pedis artery and the deep fibular nerve. Because the design of a neurovascular free flap requires detailed knowledge of the nerve and vascular supply, the data presented here are intended to help surgeons during surgical approaches to the foot and ankle.

Dorsalis pedis artery pseudoaneurysm after Lisfranc surgery

We present a 44-year-old man who sustained a Lisfranc dislocation complicated by a dorsalis pedis pseudoaneurysm. This case represents a rare complication of a commonly performed orthopaedic procedure.

Ruptured isolated external iliac artery true aneurysm associated with cystic medial necrosis: report of a case

We report a case of a ruptured isolated true external iliac artery aneurysm (EIAA). A 78-year-old woman was admitted to our institution in a shock state after the sudden onset of severe pain in the right hypogastric region. A pulsating mass was found in her right lower abdomen. Computed tomography (CT) with contrast medium showed an isolated EIAA, 40 mm in diameter, with a massive retroperitoneal hematoma. She underwent emergency resection of the aneurysm and reconstruction of the affected artery, without any complications. Histological examination confirmed a true aneurysm caused by cystic medial necrosis (CMN). She had no ocular, cardiac, or orthopedic abnormalities. We review the literature on isolated true aneurysms of the external iliac artery, which are extremely rare, and discuss their clinical manifestations.

Lateral plantar artery aneurysm: a case report

We report a case of a true plantar artery aneurysm in an adult. True aneurysms of the inframalleolar vessels are rare. The limited literature on the subject is reviewed, including differential diagnosis and suggested treatment.

Dorsalis pedis aneurysm: ultrasound diagnosis

Aneurysm and pseudoaneurysm of the dorsalis pedis artery are rare vascular entities, producing a focal soft tissue mass in the dorsal foot. A case of dorsalis pedis aneurysm is reported, illustrating the utility of ultrasound as the key imaging modality for prompt, accurate diagnosis.