Aneurysm of the Tibio-Peroneal Trunk: Case Report

Endovascular coil embolization of a large tibioperoneal trunk pseudoaneurysm

“…The most common cause of tibioperoneal trunk aneurysm is arterial infection secondary to infective endocarditis. 2 , 3 , 4 , 5 , 6 , 7 Other causes include trauma, 8 iatrogenic trauma, 9 Behçet disease, 10 , 11 and arteriosclerosis, 12 but some cases are idiopathic. 13 , 14 In this case, no obvious predisposing factors other than a history of surgery to the left calf were detected by a careful review of the patient's medical history and preoperative examinations.…”

“…Symptomatic patients with tibioperoneal trunk aneurysm typically present with chronic calf pain or swelling. Atypical presentations such as blue toe syndrome, 15 neurologic compromise resulting from compartment syndrome, 6 , 14 and acute pain with limb ischemia due to rupture of an aneurysm 7 , 10 have also been reported. Some patients are asymptomatic and the aneurysm is detected incidentally even if it is large.…”

Management of tibioperoneal trunk aneurysm in a patient with Behçet disease

“…Aneurysmal degeneration in this disease is probably due to obliterative endarteritis of the vasa vasorum supplying the medium-sized and large vessels. 4 These are more preferably treated with endovascular than with open repair. 5 , 6 , 7 , 8 Endovascular procedures are effective and safe, with acceptable complication rates and good durability.…”

“… 9 After careful literature search, we identified eight cases of patients with TPT aneurysms, 4 , 9 , 10 , 11 , 12 , 13 , 14 only one of which was secondary to Behçet disease. 4 The aneurysm was 6.6 cm in diameter and was resected, followed by a below-knee popliteal to distal posterior tibial artery bypass using reversed ipsilateral great saphenous vein graft. Two of the other reported TPT aneurysms were due to atherosclerosis, 13 , 14 and the remaining five were of unspecified etiology.…”

“… 3 , 17 On the other hand, possible procedure-related complications after open aneurysm excision and bypass include acute graft occlusion, long-term restenosis, aneurysm recurrence, and fistula formation at the anastomotic site. 4 The establishment of remission before the surgical intervention has been shown to decrease postoperative complications. Immunosuppressive therapy, such as oral prednisone, azathioprine, cyclosporine, and others, is given before and after surgery to prevent early and late postoperative complications.…”