Hereditary multiple exostoses as a novel cause of bilateral popliteal artery aneurysms in the elderly

Ferrari, Eliza J.; Crotty, Rory; Eikermann-Haerter, Katharina; Stone, James R.

doi:10.1016/j.carpath.2017.07.001

Cited by 4 publications

(3 citation statements)

References 44 publications

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“…However, vascular damage can occur with direct contact between the vessel wall and a growing osteochondroma. In these cases, histological studies show chronic scarring of the media with smooth muscle cell loss, fragmentation, and loss of the internal elastic lamina [3]. Given the histological pattern described above and the usual location of these bony lesions it is not surprising that popliteal artery pseudoaneurysm is the most common vascular injury associated with osteochondromas.…”

Section: Discussionmentioning

confidence: 95%

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Superficial Femoral Artery Pseudoaneurysm Secondary to a Femoral Osteochondroma: A Case Report and Review of the Literature

Mandujano¹,

Romero-Vélez²,

Valladares³

et al. 2020

SCR

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Background: Osteochondromas or Osteocartilaginous Exostosis are cartilage-capped bony growths arising from external bone surfaces. They typically occur at the level of growth plates and account for 30% of benign bone tumors. Vascular complications from osteochondromas are rare with roughly 112 reported cases in the literature dating back as early as 1953. Vascular injuries are location dependent, with popliteal pseudoaneurysms being the most prevalent. The operative techniques to repair these injuries have varied over time and are related to the location, degree of vascular injury, presence of thrombosis or infection and involvement of nearby structures like named veins or nerves. We present a case of a superficial femoral artery (SFA) injury secondary to an osteochondroma and offer a review of the literature evaluating the trends on operative repairs and their association with the degree of vascular injury. Methods: A total of 112 publications were found and independently reviewed. Articles containing age, sex, presentation, size of the aneurysm and surgical technique for repair were included for evaluation. Mean follow up, use of anticoagulation, and whether there was associated trauma was also recorded if reported by the authors. Articles with insufficient reported variables were excluded. A total of 49 publications were selected for evaluation based on these criteria. The review of literature was performed through PubMed, MEDLINE, NCBI using the words "pseudoaneurysm", "superficial femoral artery", "popliteal artery", and "osteochondroma". Results: Young Males were the most prevalent group (79.4%) with a mean age of 21.4 years of age. The most common complaint at presentation was pain and a palpable mass (81%) with no history of trauma (51%). Popliteal aneurysms (85%) were the most common vascular injury while the average size of injury was 5 mm. Operative techniques included arterioplasty (30.6%), end to end anastomosis (20.4%), greater saphenous vein (GSV) patch (20.4%) GSV bypass (8.1%) GSV interposition graft (8.1%) and xenopericardial or polytetrafluoroethylene (PTFE) patch (2%). Smaller arterial injuries (<5 mm) were most commonly managed with arterioplasty or end-to-end anastomosis. Conclusion: Vascular injuries secondary to osteochondromas are rare. High suspicion and prompt diagnosis are necessary to prevent long-term sequelae from neurovascular compromise. Smaller arterial defects appear to be best suitable for primary reconstruction either by arterioplasty or aneurysmectomy with end-to-end anastomosis. Ultimately, the surgical reconstruction needs to be guided in a case-by-case basis.

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Section: Discussionmentioning

confidence: 95%

“…Furthermore, conditions like Hereditary Multiple Osteochondromas (HMO) and Hereditary Multiple Exostoses (HME) are inherited diseases characterized by the presence of two or more osteochondroma. These diseases are secondary to an autosomal dominant mutation in tumor suppressor genes EXT1 or EXT2 [2,3].…”

Section: Introductionmentioning

confidence: 99%

Superficial Femoral Artery Pseudoaneurysm Secondary to a Femoral Osteochondroma: A Case Report and Review of the Literature

Mandujano¹,

Romero-Vélez²,

Valladares³

et al. 2020

SCR

View full text Add to dashboard Cite

show abstract

“…In treating individuals with lower extremity arterial complications secondary to MHE, there is no standard of care, owing to its uncommon occurrence. Nonetheless, previously published reports 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 have described nearly identical modes of management; namely, excision of the culprit osteochondroma and open vascular repair ( Table ). Only one case was managed medically, an early report of superficial femoral artery occlusion 8 that yielded recanalization and improvement in ischemic rest pain with only anticoagulation and lumbar sympathectomy.…”

Section: Discussionmentioning

confidence: 99%