A Case of Idiopathic Pseudoaneurysm of the Posterior Tibial Artery in the Ankle

Abstract

Idiopathic pseudoaneurysm of the posterior tibial artery rarely occurs in the ankle. This case report describes an asymptomatic 65-year-old female patient who presented with swelling behind the right medial malleolus. Computed tomographic angiography revealed a 23 mm pseudoaneurysm with a mural thrombus in the distal posterior tibial artery and occlusion of the distal anterior tibial artery. Excision of the pseudoaneurysm and reconstruction of the posterior tibial artery, with direct end-to-end anastomosis, was performed electively since doppler and oximetry studies demonstrated that the right posterior tibial artery was the main arterial supply to the foot and it was easy to access surgically. The postoperative course was uneventful; on day 21 postoperatively, computed tomographic angiography demonstrated patency of the right posterior tibial artery. Surgical treatment should, therefore, be considered as a first choice because arterial access in the ankle is easier compared to more proximal lesions.