Pseudoaneurysm of Anterior Tibial Artery following Tibial Nailing: A Case Report

Inamdar, Dr. MD. Furquan; Alagappan, Muthuraman; Shyam, L; Devadoss, Sathish; Devadoss, A. Victor

doi:10.1177/230949900501300216

Cited by 37 publications

(31 citation statements)

References 7 publications

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“…It may present as a pulsatile and painful swelling after surgery or may be confused with a haematoma, leading to a delay in diagnosis [5]. Previous cases of pseudoaneurysm have been reported following intramedullary nailing for tibial [6] and femoral fractures [7]. After an extensive search of the available literature, we believe that our case may be the first reported pseudoaneurysm following a retrograde nail used in ankle fusion.…”

Section: Discussionmentioning

confidence: 92%

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Pseudoaneurysm of the Anterior Tibial Artery following Tibio-Talar-Calcaneum Fusion with a Retrograde Nail: A Rare Case and Literature Review

Craxford

Karuppiah

Milner

2013

Case Reports in Orthopedics

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This study reports the case of an 87-year-old woman who presented with a nonresolving haematoma 13 weeks following tibiotalar arthrodesis surgery on her right ankle using a retrograde nail. This was revealed by angiography to be a pseudoaneurysm of the anterior tibial artery. The patient subsequently underwent endovascular stenting of the pseudoaneurysm and has had a successful recovery. This case highlights the need for awareness of both the normal arterial supply to the leg and ankle as well as the potential for anatomical variations. Arterial variation may be as high as 6.7% based on published findings from cadaveric studies. As pseudoaneurysm is a rare complication, a high index of suspicion is needed in order to avoid a missed or delayed diagnosis. We urge surgeons to keep in mind the potential for pseudoaneurysm when a patient presents with a nonresolving haematoma and arrange appropriate further investigations as needed.

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Section: Discussionmentioning

confidence: 92%

“…Endovascular therapies include coil embolisation [12], thrombin injection [13], or, as in our case, endovascular stent insertion [14]. Prompt management of a proven pseudoaneurysm is needed due to the progressive risk of enlargement and eventual rupture [6]. …”

Section: Discussionmentioning

confidence: 99%

Pseudoaneurysm of the Anterior Tibial Artery following Tibio-Talar-Calcaneum Fusion with a Retrograde Nail: A Rare Case and Literature Review

Craxford

Karuppiah

Milner

2013

Case Reports in Orthopedics

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“…Endovascular therapies include endovascular stent insertion [13], thrombin injection [14], or, as in our case, endovascular coil embolisation [15]. Without timely management, a pseudoaneurysm may continue to enlarge or eventually rupture, potentially exposing the patient to severe haemorrhage [16]. This was especially relevant in our patient, who likely suffered greater blood loss from her pseudoaneurysm due to anticoagulation for PE.…”

Section: Discussionmentioning

confidence: 97%

Arterial Injury to the Profunda Femoris Artery following Internal Fixation of a Neck of Femur Fracture with a Compression Hip Screw

Craxford

Gale

Lammin

2013

Case Reports in Orthopedics

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We report the case of an 82-year-old woman who developed extensive proximal thigh swelling and persistent anaemia following internal fixation of an extracapsular neck of femur fracture with a dynamic hip screw (DHS). This was revealed to be a pseudoaneurysm of a branch of profunda femoris artery on angiography. Her case was further complicated by a concurrent pulmonary embolism (PE). She underwent endovascular coil embolisation of the pseudoaneurysm. An IVC filter was inserted and the patient was fully anticoagulated once it had been ensured that there was no active bleeding. In this case, we review the potential for anatomical variations in the blood supply to this region and discuss treatment options for a complicated patient. We recommend that a pseudoaneurysm should be part of a differential diagnosis for postoperative patients with anaemia refractory to blood transfusion so as not to miss this rare but potentially serious complication.

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“…[3][4][5] Most endovascular experience with arterial trauma results from the treatment of arterial and arteriovenous fistula pseudoaneurysms. 6 Potential advantages of endovascular treatment are based on the fact that surgical procedures generally demand longer hospital stay and are associated with higher morbidity rates. 7,8 Preoperative angiography can accurately estimate the diameter and extension of the injured arterial segments, as well as the nature of the lesion.…”

Section: Discussionmentioning

confidence: 99%

Endovascular treatment of complex traumatic lesions of the infrapopliteal segment

et al. 2009

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Pseudoaneurysm of Anterior Tibial Artery following Tibial Nailing: A Case Report

Abstract: of the proximal interlocking screws to prevent this rare complication.

Cited by 37 publications

References 7 publications

Pseudoaneurysm of the Anterior Tibial Artery following Tibio-Talar-Calcaneum Fusion with a Retrograde Nail: A Rare Case and Literature Review

Pseudoaneurysm of the Anterior Tibial Artery following Tibio-Talar-Calcaneum Fusion with a Retrograde Nail: A Rare Case and Literature Review

Arterial Injury to the Profunda Femoris Artery following Internal Fixation of a Neck of Femur Fracture with a Compression Hip Screw

Endovascular treatment of complex traumatic lesions of the infrapopliteal segment

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