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van den Hoven P, Fosbøl E, Ljungquist O, Sörelius K. Infective native aneurysms of the infrapopliteal arteries - A systematic literature review and report of two cases. Vasc Med 2024:1358863X241245417. [PMID: 38708683 DOI: 10.1177/1358863x241245417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2024]
Abstract
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.
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Affiliation(s)
- Pim van den Hoven
- Department of Vascular Surgery, Rigshospitalet, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Emil Fosbøl
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Cardiology, Rigshospitalet, Copenhagen, Denmark
| | - Oskar Ljungquist
- Department of Infectious Diseases, Helsingborg Hospital, Helsingborg, Sweden
- Department of Clinical Sciences, Division of Infection Medicine, Lund University, Lund, Sweden
| | - Karl Sörelius
- Department of Vascular Surgery, Rigshospitalet, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Crisp J, Ahmad M, Crockett S, Mohamed A, Hamady M, Bernstein O, Shalhoub J. Spontaneous bilateral superficial femoral artery pseudoaneurysms and a unilateral posterior tibial artery aneurysm in an immunocompromised patient. Clin Case Rep 2024; 12:e8686. [PMID: 38515996 PMCID: PMC10954564 DOI: 10.1002/ccr3.8686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 01/28/2024] [Accepted: 02/07/2024] [Indexed: 03/23/2024] Open
Abstract
Key Clinical Message The presence of multiple pseudoaneurysms in a patient should prompt investigations for the underlying etiologies including autoimmune and immunosuppressive disease processes. Treatment options include open repair and endovascular stenting. Abstract Pseudoaneurysms (also known as false aneurysms) are atypical dilatations or outpouchings from a vessel which are not always contained by the three layers of a normal vessel wall, namely the intima, media, and adventitia. These are distinct from a true aneurysm which has a wall comprising all three layers. The underlying etiology for both true aneurysms and pseudoaneurysm can vary. We present the rare case of bilateral superficial femoral artery pseudoaneurysms, of unknown etiology and a concurrent posterior tibial artery saccular aneurysm in a patient with Human Immunodeficiency Virus (HIV) infection and multiple comorbidities. This was managed using a combination of endovascular covered stent grafts and open surgical repair technique. The patient is doing well on follow-up a year later with no post-operative infections. A literature review of the existing reports of superficial femoral artery pseudoaneurysms and posterior tibial artery aneurysms and their management is also reported.
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Affiliation(s)
- Jonathan Crisp
- Department of Vascular SurgeryImperial College Healthcare NHS TrustLondonUK
| | - Manal Ahmad
- Department of Vascular SurgeryImperial College Healthcare NHS TrustLondonUK
- Department of Surgery and CancerImperial College LondonLondonUK
| | - Stephen Crockett
- Department of Vascular SurgeryImperial College Healthcare NHS TrustLondonUK
- Department of Surgery and CancerImperial College LondonLondonUK
| | - Abdulla Mohamed
- Department of Vascular SurgeryImperial College Healthcare NHS TrustLondonUK
| | - Mohamad Hamady
- Department of Vascular SurgeryImperial College Healthcare NHS TrustLondonUK
- Department of Surgery and CancerImperial College LondonLondonUK
- Department of RadiologyImperial College Healthcare NHS TrustLondonUK
| | - Ondina Bernstein
- Department of Vascular SurgeryImperial College Healthcare NHS TrustLondonUK
- Department of Surgery and CancerImperial College LondonLondonUK
- Department of RadiologyImperial College Healthcare NHS TrustLondonUK
| | - Joseph Shalhoub
- Department of Vascular SurgeryImperial College Healthcare NHS TrustLondonUK
- Department of Surgery and CancerImperial College LondonLondonUK
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Tonogai I, Arase H, Kawabata Y, Sairyo K. Septic True Aneurysm of the Posterior Tibial Artery Diagnosed after Anterior Arthroscopic Debridement of a Septic Ankle following Infective Endocarditis: A Case Report. J Orthop Case Rep 2019; 8:68-73. [PMID: 30915299 PMCID: PMC6424318 DOI: 10.13107/jocr.2250-0685.1264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Introduction There have been reports of true aneurysm of the posterior tibial artery, but only three reports have described true aneurysm of the posterior tibial artery at the ankle, and there has been only one report of tarsal tunnel syndrome caused by true aneurysm of this artery. In this case report, we describe a rare case of true septic aneurysm of the posterior tibial artery presenting as tarsal tunnel syndrome which was found after anterior arthroscopic debridement of a septic ankle in a 55-year-old man. Case Report 13 years earlier, this patient had undergone aortic valve replacement for severe aortic regurgitation caused by infective endocarditis with aortic valve vegetations. Since then, the patient had been treated with the oral anticoagulant warfarin. The aneurysm was successfully treated by a saphenous vein graft and administration of antibiotics. The patient likely developed septic ankle and aneurysm as a consequence of infective endocarditis. Conclusions Magnetic resonance imaging should be performed before arthroscopic surgery to rule outaneurysm, especially in a patient with a septic ankle and/ora history of infective endocarditis.
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Affiliation(s)
- Ichiro Tonogai
- Department of Orthopedics, Institute of Biomedical Science, Tokushima University Graduate School, 3-18-15 Kuramoto, Tokushima 770-8503, Japan
| | - Hiroki Arase
- Department of Cardiovascular Surgery, Institute of Biomedical Science, Tokushima University Graduate School, 3-18-15 Kuramoto, Tokushima 770-8503, Japan
| | - Yutaka Kawabata
- Department of Cardiovascular Medicine, Institute of Biomedical Science, Tokushima University Graduate School, 3-18-15 Kuramoto, Tokushima 770-8503, Japan
| | - Koichi Sairyo
- Department of Orthopedics, Institute of Biomedical Science, Tokushima University Graduate School, 3-18-15 Kuramoto, Tokushima 770-8503, Japan
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Sagar J, Button M. Posterior tibial artery aneurysm: a case report with review of literature. BMC Surg 2014; 14:37. [PMID: 24934412 PMCID: PMC4112977 DOI: 10.1186/1471-2482-14-37] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Accepted: 05/28/2014] [Indexed: 01/02/2023] Open
Abstract
Background Aneurysms infra-patellar region are uncommon. Of them, true aneurysms are very rare and that of posterior tibial artery are extremely rare. The more common, pseudoaneurysms are commonly associated with trauma whereas the true ones are linked with either inflammatory or mycotic origins. Case Presentation We reported another case of true aneurysm of posterior tibial artery without any evident aetiology. This was repaired with resection of aneurysm followed by interposition vein graft. Conclusion Through this report, we discussed the rarity, review of literature and management of this unusual condition.
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Affiliation(s)
- Jayesh Sagar
- Department of Vascular Surgery, Royal Sussex County Hospital, Brighton BN1 2HS, UK.
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Domenick N, Cho JS, Abu Hamad G, Makaroun MS, Chaer RA. Endovascular repair of multiple infrageniculate aneurysms in a patient with vascular type Ehlers-Danlos syndrome. J Vasc Surg 2011; 54:848-50. [DOI: 10.1016/j.jvs.2011.01.035] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2010] [Revised: 01/11/2011] [Accepted: 01/12/2011] [Indexed: 11/25/2022]
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Ferrero E, Ferri M, Viazzo A, Gaggiano A, Berardi G, Piazza S, Cumbo P, Castagno C, Pecchio A, Nessi F. Rupture of a True Giant Aneurysm of the Posterior Tibial Artery: A Huge Size of 6 cm on Diameter. Ann Vasc Surg 2010; 24:1134.e9-13. [DOI: 10.1016/j.avsg.2010.01.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2009] [Revised: 01/21/2010] [Accepted: 01/29/2010] [Indexed: 11/16/2022]
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Naughton PA, Wang TT, Keeling AN, Moneley D, Kelly CJ. Down Syndrome: A Risk Factor For Mycotic Aneurysm? Vascular 2010; 18:297-8. [DOI: 10.2310/6670.2010.00040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Down syndrome, or trisomy 21, has a characteristic constellation of clinical findings, including various congenital heart defects. We report a case of an adult male with Down syndrome who presented with a 3-week history of lower limb pain and swelling, attributed to cellulitis. Clinical and angiographic evaluation identified a below-knee mycotic pseudoaneurysm secondary to infective endocarditis. Surgical aneurysmal repair and revascularization were performed. Various management options are outlined in this report.
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Affiliation(s)
- Peter A. Naughton
- Departments of *Vascular Surgery and †Academic Radiology, Beaumont Hospital, Dublin, Ireland
| | - Tim T. Wang
- Departments of *Vascular Surgery and †Academic Radiology, Beaumont Hospital, Dublin, Ireland
| | - Aoife N. Keeling
- Departments of *Vascular Surgery and †Academic Radiology, Beaumont Hospital, Dublin, Ireland
| | - Darragh Moneley
- Departments of *Vascular Surgery and †Academic Radiology, Beaumont Hospital, Dublin, Ireland
| | - Cathal J. Kelly
- Departments of *Vascular Surgery and †Academic Radiology, Beaumont Hospital, Dublin, Ireland
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Antonopoulos C, Karagianni M, Galanakis N, Vagianos C. Mycotic Splenic Artery Aneurysm Secondary to Coxiella burnetii Endocarditis. Ann Vasc Surg 2010; 24:416.e13-6. [DOI: 10.1016/j.avsg.2009.05.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2009] [Accepted: 05/27/2009] [Indexed: 10/20/2022]
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Abstract
We reviewed all papers most recently reported in the literature related to infected arterial aneurysms (IAAs) affecting the aorta and vascular beds other than the aorta. In this article, we report on vascular beds other than the aorta. As is the case for aortic IAAs, infected non-aortic aneurysms are rarely encountered. The majority of recent studies are limited to case reports and small series of unusual infected aneurysms. A comprehensive review of this entity was performed based on the available literature from January through December 2008 in all languages. Available reports were analyzed with respect to demographic features, type of presentation, methods of diagnosis and therapy, follow-up, and outcome (morbidity and mortality).
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Affiliation(s)
- Luis R León
- Tucson Medical Center and Carondelet Health Network-Department of Vascular Surgery, University of Arizona Health Science Center, Agave Surgical Associates, 5240 East Knight Drive, Suite 118, Tucson, AZ 85712, USA.
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