2016 Volume 25 Pages 341-345
Solitary pseudoaneurysm of the anterior tibial artery without bone fracture rarely occurs as a complication of trauma to the lower extremities. We report a case with pseudoaneurysm of the anterior tibial artery, presumably caused by a trauma incurred 25 years ago. The patient was a 61-year-old woman who visited a local health care facility complaining of pain in her left lower extremity. Plain radiography revealed lateral deformity of the tibia without fracture. MRI showed a solid tumor with well-defined borders. Initially, the patient was referred to the department of orthopedics in our hospital, with suspicion of bone tumor. Ultrasonography of the lower extremity revealed a pseudoaneurysm with mural thrombus, not a solid tumor. Subsequently, the patient was referred to our department. CT angiography revealed a saccular pseudoaneurysm of the anterior tibial artery. Primary closure of disrupted anterior tibial artery was performed. Bypass surgery using saphenous vein was also conducted because peripheral perfusion was decreased just after the primary closure. No postoperative complications were observed, and the patient was discharged on postoperative day 9 uneventfully. Graft patency and shrinkage of the pseudoaneurysm was observed using duplex ultrasonography over 2-year follow-up.
