A case report of an anterior tibial artery pseudo-aneurysm open surgical management: A rare complication post total knee arthroplasty. (2017)

• Record Type: Journal Article
• Authors: Darius Aw, Kang Lie; Tan, Choon Chieh; Ch'ng, Jack Kian; Chng, Siew Ping
• Is Part Of: International journal of surgery case reports. Volume 37(2017)
• Page Start: 196
• Page End: 199
• Publication Date: 2017
• Subjects: Case report -- Tibial artery false aneurysm -- Total knee arthroplasty -- False aneurysm repair -- Endovascular technique; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; Surgery; Electronic journals; Periodicals; 617.005
• DOI: 10.1016/j.ijscr.2017.06.037
• Languages: English
• ISSNs: 2210-2612

Abstract

Highlights: Anterior tibial artery (ATA) pseudo aneurysm is rare after total knee arthroplasty. Pseudo aneurysms can be asymptomatic or present with nerve palsy or rupture. Diagnosis can be made with noninvasive imaging or digital subtraction angiography. Ligation of the ATA and excision of its aneurysm is a safe and durable solution. Abstract: Introduction: Complications involving injury to neurological and vascular structures are infrequently reported after total knee arthroplasty (TKA). They are associated with significant morbidity and can be limb threatening. Presentation of case: We present a patient with an anterior tibial artery (ATA) aneurysm post total knee arthroplasty. A 69-year-old female was referred for a swelling over her left antero-lateral aspect of her leg 4 years post TKA. Radiological investigations showed an ATA pseudo aneurysm. The aneurysm was repaired by open ligation. Discussion: ATA pseudo aneurysm is a rare condition post arthroplasty. Patients can complain about calf pain, digits discoloration, paresthesia and the presence of a pulsating or enlarging mass. Symptomatic aneurysms require surgical intervention. Conclusion: ATA pseudo aneurysms are uncommon. They are usually identified shortly after the initial insult. A delayed manifestation of a post knee arthroplasty complication as illustrated in our case is likely the first reported case of its kind. Clinicians should maintain a high index of suspicion should there be persistent localised swelling post TKA. However, due to the rarity of this condition, a variety of interventions have been reported in the English medical literature with probably no compelling evidence that favors one modality over the others.