Anterior Tibial Artery Pseudoaneurysm: A Case Report and Literature Review

Background Anterior tibial artery pseudoaneurysm is a very uncommon complication after orthopedic surgery and trauma. A combined treatment modality using thrombin injection, coil embolization, and surgical approach is described and currently being evaluated compared with other treatment modalities. Patient Description This study reports the case of a 33-year-old man who presented in the office with a pulsatile mass just below the right knee. The patient with a history of trauma to his right leg during a motor vehicle accident underwent open reduction internal fixation of a proximal tibia-fibula fracture. Eight weeks later the patient had a pulsatile mass in the surgical area. A venous Doppler ultrasound was initially performed in the emergency room which revealed an incidental finding of a 5.60 cm × 3.54 cm pseudoaneurysm. Methods As modalities of treatment the patient had coil embolization as well as two separate sessions of thrombin injection with poor response. Finally, he underwent repair of the right anterior tibial artery pseudoaneurysm with a vein patch, which was successful. This case highlights different modalities that have been used to treat anterior tibial artery pseudoaneurysms. Conclusion Based on previous reported cases and our own case, we concluded that surgical approach is the most successful modality of treatment for proximal anterior tibial artery pseudoaneurysms.