A True Giant Aneurysm of the Anterior Tibial Artery

Successful endovascular isolation of a huge true anterior tibial artery aneurysm by the bi‐directional approach in a young patient

“…Due to the rarity of this aneurysm, various interventions have been reported and there is no consensus about the methodology to treat crural aneurysms . Open surgical ligation with reconstruction has been reported and is superior at maintaining blood flow to the lower limb .…”

“…Open surgical ligation with reconstruction has been reported and is superior at maintaining blood flow to the lower limb . Simple ligation without reconstruction could also be considered in patients who with enough collateral flow . The other instance in which open surgery may be superior is if there are compressive symptoms and the patients may benefit from evacuation of the mural thrombus in the aneurysm sac.…”

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

“…True ATAAs are rare; a search of the available literature revealed 20 cases spanning from 1944 to 2020 (Table 1). [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] The average age of reported patients at the time of intervention was 52 with a range of 28 to 86. Sixty-five percent (n ¼ 13) were male and 35% (n ¼ 7) were female.…”

“…Nineteen of the patients were repaired by an open approach: 7 received arterial ligation (37%), 1 -4,7,11,13 4 ligation and resection (21%), 9,10,14,19 4 required autologous bypass (21%), 8,15,18 3 primary repair (16%), 6,17 and 1 coil embolization and ligation (5%). 5 While each approach has its advantages, reconstruction with saphenous interposition is considered superior by many, especially in the setting of flow-limiting peripheral vascular disease.…”

“…10 Notably, 6 (30%) had the presence of a stable mass or deformity and were otherwise asymptomatic at the time of surgery. 4,9,11,12,15,16 Debate exists on intervention for this population; most evidence supports surveillance with duplex sonography for small, asymptomatic aneurysms and intervention only when symptomatic or rapidly expanding. 18…”