Pseudoaneurysm of the popliteal artery caused by exostosis of the femur: Case report and review of the literature

Abstract

A 13-year-old boy with a solitary exostosis of the left femur was seen with a pseudo-aneurysm of the popliteal artery. When left leg pain occurred 3 months earlier, radiographic examination revealed an exostosis with a cartilage cap. Serial radiographic examination demonstrated gradual disruption of the cartilage cap of the exostosis as the pseudoaneurysm developed. An exostosis with an irregular surface was found at surgery. A literature review disclosed 39 similar cases in which loss of the cartilage cap was considered as one of the causes of the aneurysm formation. Considering the clinical course of our patient, however, we believe that exostoses lose their cartilage caps by pressure destruction due to the aneurysms. It is highly probable that loss of the cartilage does not cause the aneurysms.

Popliteal artery pseudo-aneurysm secondary to femoral osteochondroma: a case report and literature review

“…As the pseudo-aneurysm expands, it causes pressure necrosis of the cartilaginous cap. 27 In our case, the cartilaginous cap was not evident at operation. We speculate that the development of the pseudo-aneurysm was exacerbated by the episode of blunt trauma leading to compression of a weakened arterial wall against a 'non-protected' osteochondroma.…”

“…As the vessel becomes tethered, the resulting constant compression and pulsatile friction against the 'non-protected' osteochondroma causes continuous injury to the vessel wall, resulting in pseudo-aneurysm formation. [24][25][26] However, Matsushita et al 27 hypothesised that the loss of the protective cartilaginous cap was not the initiating factor, but that an initial traumatic compression of the popliteal artery against an osteochondroma leads to the development of the pseudo-aneurysm. As the pseudo-aneurysm expands, it causes pressure necrosis of the cartilaginous cap.…”

Posttraumatic pseudoaneurysm of medial plantar artery in a child: treatment with percutaneous thrombin injection

“…10,14,15 Detailed clinical history taking and physical examination are of fundamental importance for early diagnosis and should take account of time and mechanism of trauma. 8,10,16 Pain, edema and hematoma are the initial symptoms of pseudoaneurysms.…”

Pseudoaneurisma de artéria poplítea secundário a osteocondroma femoral: relato de caso

“…Por este motivo, desenvolvem-se principalmente na adolescência. Pode ser único ou múltiplo e localiza-se nas metáfises ósseas, comumente no fêmur distal [1][2][3] . Normalmente assintomático, achado casual de radiografia, pode estar associado à inúmeras complicações, incluindo deformidades do esqueleto, alterações do crescimento, compressões nervosas, limitação da mobilidade articular, fraturas do tumor e degeneração maligna.…”

“…O tratamento do pseudoaneurisma associado ao osteocondroma é cirúrgico: correção do pseudoaneurisma associado à ressecção da espícula óssea [1][2][3][4] . Pode se reconstruir a lesão arterial com enxerto venoso ou protético, secção do pseudoaneurisma com anastomose término-terminal da artéria, ou simples sutura do orifício responsável pelo pseudoaneurisma, como no relato de caso descrito …”