# А Rare Case of an Infected, Ruptured Popliteal Artery Aneurysm Occurring Following Surgical Treatment for Panaritium

## TL;DR

A 71-year-old man with a ruptured infected popliteal artery aneurysm was successfully treated with surgery and antibiotics after complications from a prior procedure and a foot infection.

## Contribution

This case highlights a rare complication of an infected, ruptured popliteal artery aneurysm following prior endovascular treatment and a foot infection.

## Key findings

- An infected and ruptured popliteal artery aneurysm was successfully treated with surgical bypass and endograft removal.
- The patient recovered well after 50 days of treatment including antibiotics and wound management with a VAC system.
- The case emphasizes the importance of urgent surgical intervention in managing such rare and complex vascular infections.

## Abstract

We present a successful case of treating an infected popliteal aneurysm in a 71-year-old man who arrived at the emergency department in a septic state, reporting a three-week history of fever, lethargy, general malaise, and pain and swelling in the right popliteal fossa. Previously diagnosed with a sizable right popliteal aneurysm, the patient had undergone endovascular treatment using a Viabahn (WL Gore & Associates, Flagstaff, USA) endoprosthesis two months earlier. His fever and malaise emerged a week following minor surgery for a toe infection (panaritium) on the right foot, leading to subsequent necrotic lymphangitis on the dorsum of the same foot. A PET/CT scan strongly indicated an infection within the aneurysmal sac, while a CT angiography confirmed the integrity of the stent graft without any leaks but revealed a ruptured aneurysm. Urgent surgical intervention was necessary. An extra-anatomical autovenous bypass was conducted, followed by an aneurysm and endograft removal. Subsequently, a vacuum-assisted closure (VAC) system was employed to manage the infected wound post sac extraction. The surgical procedure went smoothly without complications, and following a course of antibiotics, the patient recovered well, eventually being discharged after 50 days.