Pseudoaneurysm of Posterior Tibial Artery Management: Case Report and Review of Literature

Abstract

Pseudoaneurysm (PA) of posterior tibial artery (PTA) is not very common and that of middle one-third of PTA is rare. Endovascular treatment of symptomatic PAs has become a viable less invasive option compared to open repair. In this case report, a 64-year-old gentleman came with acute thrombosis of superficial femoral artery which was treated successfully by embolectomy. He later presented to us with increasing pain over the calf region which on duplex scan revealed us a PA of middle one-third of PTA. It was successfully managed by endovascular stenting without compromising the distal blood flow. An extensive review of the literature has also been performed.

Late-onset pseudoaneurysms of lower limb arteries following late complications of orthopaedic constructs - Two cases and review of literature

“…Pseudoaneurysms arising from major vessels such as axillary-brachial and femoropopliteal are repaired surgically or with endovascular stent placement [6] , [18] . Arterial repair consists of primary repair, primary anastomosis following resection of a damaged segment of the artery and venous patch graft to the defect.…”

“…Intraluminal stent placement is another successful endovascular procedure in which a covered stent is placed at the site of pseudoaneurysm to bypass the damaged arterial segment [6] , [18] . It carries lower morbidity and mortality, shorter hospital stays lesser recovery time, which preserve the saphenous vein and no donor site morbidity [1] .…”

“…Pseudoaneurysms or false aneurysms are caused by physical or biological damage to the adventitial layer of the artery leading to gradual, persistent extravasation of blood into the surrounding soft tissues that connect within the arterial lumen [1] . Mechanical causes for pseudoaneurysms are trauma (fracture, dislocation and penetrating injuries) [2] , [3] , [4] , vascular arterial interventions (anastomotic disruption and arterial cannulation procedures), and orthopaedic interventions (Drills, pins of external fixators, screws and arthroscopic portals) [4] , [5] , [6] . The biological cause for the pseudoaneurysm formation is infection [7] .…”

Transarterial endovascular coil embolization in managing intractable bleeding from fibular artery: A case report

“…Treatment of the pseudoaneurysm could be surgical and non-surgical. Non-surgical treatment includes endovascular techniques (percutaneous endovascular coil embolization and percutaneous endovascular stenting) and non-invasive techniques, such as ultrasound-guided compression and ultrasound-guided injection of thrombin [1] , [2] , [9] .…”

“…Pseudoaneurysms of the crural arteries are rare, especially the fibular artery. In literature, causes of pseudoaneurysms are mainly orthopedic interventions, such as fracture, dislocation, or surgery [2] . Owing to the benefits of endovascular techniques, including reduced blood loss, decreased morbidity, and shorter hospital stay, the endovascular approach has been preferred over open surgery if its feasibility and safety are assured [3] .…”