Posterior tibial artery pseudoaneurysm: a rare complication following orthopedic surgery—a case report

TL;DR

A rare case of a posterior tibial artery pseudoaneurysm following orthopedic surgery is reported, emphasizing the importance of accurate diagnosis and successful surgical treatment.

Contribution

This case report presents a rare vascular complication following orthopedic surgery and highlights the effectiveness of non-invasive diagnostics and surgical repair.

Findings

A posterior tibial artery pseudoaneurysm was diagnosed using Doppler ultrasonography and contrast-enhanced CT.

Open surgical repair with patch angioplasty resolved the pseudoaneurysm successfully.

The patient remained asymptomatic during follow-up periods of 3 weeks and 3 months.

Abstract

Orthopedic procedures, although commonly associated with complications such as joint infections, deep venous thrombosis, or wound infections, rarely result in vascular complications. We present a case of a posterior tibial artery (PTA) pseudoaneurysm following blunt trauma during an elective orthopedic procedure involving the removal of osteosynthesis material. The patient developed leg swelling and intermittent hemorrhage between 1 and 3 weeks postoperatively. Doppler ultrasonography and contrast-enhanced computed tomography (CT) angiography confirmed the presence of a PTA pseudoaneurysm. The patient subsequently underwent open surgical repair in our secondary center, which involved exclusion of the pseudoaneurysm at the proximal PTA and patch angioplasty using an autologous venous graft. This case highlights the critical role of non-invasive diagnostic modalities, such as Doppler ultrasonography and contrast-enhanced CT with 3D reconstruction, in diagnosing vascular complications following orthopedic procedures. The patient remained asymptomatic during both the 3-week and 3-month follow-up periods.

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