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      Post-traumatic pseudoaneurysm of the medial plantar artery with arteriovenous fistula treated by coil embolization of the main feeding artery and percutaneous thrombin injection

      case-report
      Author(s): , MD, PhD ∗ , , MD, PhD
      Publication date (Electronic):
      Journal: Journal of Vascular Surgery Cases and Innovative Techniques
      Publisher: Elsevier
      Keywords: Pseudoaneurysm, AVF, Thrombin injection, Endovascular treatment, Trauma

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          Abstract

          Endovascular treatment for post-traumatic pseudoaneurysm (PsA) has been deemed effective and minimally invasive. However, embolization of all feeding and outflow vessels is difficult if multiple fine arteriovenous fistulas (AVFs) are present. In the present case, PsA of the medial plantar artery with AVF was diagnosed 1 month after injury by a rusty nail. Treatment using a combination of embolization of only the main feeding artery and percutaneous thrombin injection into PsA was successful. This approach can completely resolve PsA in narrow vessels, such as in the foot, particularly when AVF is present with numerous connected vessels.

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          Expanded indications for ultrasound-guided thrombin injection of pseudoaneurysms.

          Heidi M. Mansour, D Filliung, M Michelini … (2000)
          We previously reported preliminary data on a new procedure that we developed for the treatment of femoral pseudoaneurysms after catheterization. This study presents our current results of percutaneous ultrasound-guided thrombin injection for treating pseudoaneurysms that arise from various locations and causes. Between February 1996 and May 1999, we performed thrombin injection of 83 pseudoaneurysms in 82 patients. There were 74 femoral pseudoaneurysms: 60 from cardiac catheterization (36 interventional), seven from peripheral arteriography (four interventional), five from intra-aortic balloon pumps, and two from dialysis catheters. There were nine other pseudoaneurysms: five brachial (two cardiac catheterization, two gunshot wounds, one after removal of an infected arteriovenous graft), one subclavian (central venous catheter insertion), one radial (arterial line), and one distal superficial femoral and one posterior tibial (both after blunt trauma). Twenty-nine pseudo-aneurysms were injected while on therapeutic anticoagulation. Patients underwent repeat ultrasound examination within 5 days and after 4 weeks. Eighty-two of 83 pseudoaneurysms had initial successful treatment by this technique, including 28 of 29 in patients who were undergoing anticoagulation therapy. The only complication was thrombosis of a distal brachial artery, which resolved spontaneously. There were early recurrences in seven patients: four patients underwent successful reinjection; reinjection failed in two patients, who underwent surgical repair; and one patient had spontaneous thrombosis on follow-up. After 4 weeks, ultrasound examinations were completely normal or showed some residual hematoma, and there were no recurrent pseudoaneurysms. Ultrasound-guided thrombin injection of pseudoaneurysms has excellent results, which support its widespread use as the primary treatment for this common problem.
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            Endovascular treatment of a post-traumatic tibial pseudoaneurysm and arteriovenous fistula: case report and review of the literature.

            Rita Spirito, Piero Trabattoni, Giulio Pompilio … (2007)
            Here we report a rare case of a 74-year-old man with a pseudoaneurysm of the anterior tibial artery and a concomitant arteriovenous fistula (AVF). The patient was admitted because of increasing pain following the formation of a large mass located in the anterior mid-portion of the calf after a moderate non-penetrating blunt trauma. A polytetrafluoroethylene-covered stent was placed over the origin of the pseudoaneurysm, with complete exclusion of the pseudoaneurysm and disappearance of the AVF. One year after the procedure the mass had completely disappeared and the vascular anatomy of the calf is well preserved.
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              Pseudoaneurysms around the foot and ankle: Case report and literature review

              J.L. Yu, E Ho, A.P. Wines (2013)
              Pseudoaneurysms developing around the foot and ankle are known to be an uncommon complication following surgery. We present a case of a pseudoaneurysm following ankle surgery for a tibial plafond fracture and comprehensively review the literature with emphasis on their anatomic location, aetiology and treatment options.
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                Author and article information

                Contributors
                Yuta Tajima
                Journal
                Journal ID (nlm-ta): J Vasc Surg Cases Innov Tech
                Journal ID (iso-abbrev): J Vasc Surg Cases Innov Tech
                Title: Journal of Vascular Surgery Cases and Innovative Techniques
                Publisher: Elsevier
                ISSN (Electronic): 2468-4287
                Publication date PMC-release: 27 October 2020
                Publication date Collection: March 2021
                Publication date (Electronic): 27 October 2020
                Volume: 7
                Issue: 1
                Pages: 51-55
                Affiliations
                [1]Department of Vascular Surgery, Osaki Citizen Hospital, Miyagi, Japan
                Author notes
                [∗ ]Correspondence: Yuta Tajima, MD, PhD, Department of Vascular Surgery, Osaki Citizen Hospital, 3-8-1, Honami, Furukawa, Osaki city, Miyagi prefecture 989-6183, Japan yuta.tajima.a6@ 123456tohoku.ac.jp
                Article
                Publisher Item ID: S2468-4287(20)30187-8
                DOI: 10.1016/j.jvscit.2020.10.012
                PMC ID: 7903191
                SO-VID: 3fcf3f4f-6bcf-4a9e-9547-83d00470a5a2
                Copyright © © 2020 The Authors
                License:

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                Date received : 1 August 2020
                Date accepted : 16 October 2020
                Categories
                Subject: Case report

                Keywords: pseudoaneurysm,avf,thrombin injection,endovascular treatment,trauma
                Data availability:
                Keywords: pseudoaneurysm, avf, thrombin injection, endovascular treatment, trauma

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