Coil embolization of an aberrant posterior tibial artery pseudoaneurysm after total knee arthroplasty

Abstract

Arterial injury is a recognized but rare complication of total knee arthroplasty. These injuries, however, can be exceptionally devastating and potentially result in limb loss. Presentation may be delayed with symptoms associated with mass effect rather than with ischemia. We describe treatment of a patient with presentation delayed 2 weeks. In addition, the patient's arterial branch pattern demonstrated aberrant anatomy with high takeoff of the posterior tibial artery. This patient was successfully treated with transcatheter coil embolization. The current treatment options and published literature are reviewed.

Endovascular treatment of a post-traumatic pseudoaneurysm arising from a ruptured posterior tibial artery with Menox. A case report

“…In contrast to true aneurysms, PSAs are contained by the adventitia or surrounding soft-tissue structures making them more prone to rupture and therefore requiring urgent management [1] . PTA PSAs are extremely uncommon and they typically occur because of penetrating or blunt trauma [2] , fractures of the lower limb [3] and orthopedic procedures [4] . They usually present with pain, swelling or an expanding pulsatile mass, while the severity of the symptoms is associated with the size of the PSA [5] .…”