Posttraumatic versus Mycotic Dorsalis Pedis Pseudoaneurysm

Infective native aneurysms of the infrapopliteal arteries - A systematic literature review and report of two cases

Infective native aneurysms (INA) of the infrapopliteal arteries are rare and have previously been poorly described. This systematic review aims to provide an overview of the literature of this entity. Furthermore, two case reports of our own clinical experience are presented. PubMed, ScienceDirect, Cochrane, Ovid Embase, Ovid MEDLINE, and Web of Science were searched for articles on INAs of the infrapopliteal segment from January 1990 to September 2023. Article screening and selection were performed adhering to PRISMA guidelines. A total of 98 articles were screened and 20 were eligible for inclusion, of which all were case reports. In total, 22 patients with 28 infrapopliteal INAs were identified. The majority of INAs were located in the tibioperoneal trunk (n = 10, 36%) followed by the posterior tibial artery (n = 7, 25%). A current, or history of, infective endocarditis (IE) was described in 18 out of 22 patients (82%). Two patients died during hospitalization and one patient required a transfemoral amputation. A conservative antibiotic-only approach was chosen in three out of 28 INAs, two of which were the case reports described in this article; surgical or endovascular intervention was performed in 19 out of 28 aneurysms. No complications occurred in the conservative group, but one complication (transfemoral amputation) occurred in the interventional group. Infrapopliteal INA is a rare entity, and most described cases are precipitated by IE. Surgery or endovascular treatment might be indicated, but more research is warranted to define which patient would benefit and by what surgical approach.

Successful surgical repair of an eminently rare case of an incidental idiopathic Common Femoral Artery Pseudoaneurysm in a 6-year-old female child - A Case Report

INTRODUCTION AND IMPORTANCE

A Pseudoaneurysm is an abnormal outpouching of the arterial wall which progressively enlarges and could lead to catastrophic consequences. Ensuing damage could culminate in the loss of the affected extremity due to dissection, exsanguination, thromboembolism, or infection. Some presentations are symptomatic, whereas others are incidental findings. Timely surgical mediation is vital to eliminate the potential morbid sequelae.

CASE PRESENTATION

We present the case of a 6-year-old female, who was referred to the clinic due to an incidental finding of a pulsatile bulge in her right groin. We confirmed the presence of a visible pulsating bulge in the right groin associated with impalpable Popliteal and Pedal pulses. Preoperative imaging revealed an isolated Common Femoral Artery Pseudoaneurysm and hence, surgical intervention was successfully accomplished.

CLINICAL DISCUSSION

Surgical repair was achieved by pseudoaneurysmectomy and utilizing an autologous Saphenous Vein graft. From the proximal side, a primary end-to-end anastomosis was accomplished between the veinous graft and the right Common Femoral Artery (CFA). Whereas from the distal side, a direct end-to-end anastomosis was completed between the right Superficial Femoral Artery and the veinous graft.

CONCLUSION

Arterial pseudoaneurysms constitute immensely rare vascular emergencies. The pediatric population is particularly vulnerable because of the rarity of occurrence of this pathology in children. Surgical intervention is the gold standard approach. Meticulous follow-up protocols ought to be carried-out to limit the possibility of recurrence. Documentation is the main building block in our profession. Physicians should possess high sense of clinical awareness when presented with such a pathology.

Dorsalis pedis artery pseudoaneurysm: A rare entity in the field of vascular surgery

Introduction

Dorsalis pedis artery aneurysms (PDAA) and pseudoaneurysms are rare conditions of lower limb vasculature. The rarity of the disease increases in the pediatric age group where only 4 cases of pediatric patients with PDAA.

Presentation of the case

We present A case of a 2-year-old baby girl who was diagnosed with dorsalis pedis pseudoaneurysm, which was treated successfully with pseudoaneurysm dissection and anastomosis.

Clinical discussion

The dorsalis pedis pseudoaneurysm in this case has a rare anatomical location in addition to the unusual onset at this age group. Due to the rarity of this condition among all age groups, there is not a well-structured approach.

Conclusion

DPAA/pseudoaneurysm is a rare entity in the field of vascular surgery. Medical treatment is not suitable for DPAA/pseudoaneurysm to avoid the future risk of thrombosis or ischemia. The surgical approach is the Mainstay of treatment.

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Dorsalis pedis artery aneurysms (PDAA) and pseudoaneurysms are rare conditions of lower limb vasculature.

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This condition is even extremely rare in pediatric age group.

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The vast majority of Dorsalis pedis artery pseudoaneurysms are caused by traumatic injury.

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The usual clinical presentation of PDAA is occasionally painful pulsating mass in the dorsum of the foot.

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DPAA treatment is surgical.

Pseudoaneurysm of the Dorsalis Pedis Artery: Case Report and Literature Review

Aneurysms and pseudoaneurysms of the dorsalis pedis artery are rare vascular entities usually caused by traumatic injury or iatrogenic intervention, producing a focal soft pulsatile tissue mass in the dorsal foot. Gradual expansion of the fibrous capsule can produce secondary physical signs through the pressure exerted on surrounding structures. We report the case of a 57-year-old male with an idiopathic pseudoaneurysm of the dorsalis pedis artery. A focused history found a low-grade blunt trauma to the dorsal foot that had occurred 2 years previously. The diagnosis of a pseudoaneurysm was confirmed by ultrasound examinations and computed tomography angiograms. The pseudoaneurysm was treated with resection, and a short reversed great saphenous vein interposition graft was placed. He recovered well after surgery and remained free of symptoms 18 months postoperatively. The literature review of this uncommon vascular pathologic entity and the diagnosis and management are discussed.

Endovascular Treatment of a Dorsalis Pedis Artery Pseudoaneurysm

Pseudoaneurysm of the dorsalis pedis artery (DPA) is an extremely rare entity that most commonly occurs secondary to trauma or surgery. All reported cases describe surgical treatment. We illustrate a case of enlarging DPA pseudoaneurysm causing pain and disability in a 49-year-old woman who was treated with transcatheter embolization and pseudoaneurysm aspiration resulting in near-immediate resolution of symptoms.

A true giant aneurysm of the anterior tibial artery

Aneurysms of the anterior tibial artery are rare. We will describe a case of a woman with an asymptomatic true aneurysm of the anterior tibial artery. The patient presented with a pulsatile mass in the lateral face of the distal portion of the left leg, and both ultrasound examination and computed tomography angiography scan showed a giant aneurysm of the anterior tibial artery. We chose open treatment.