Popliteal artery pseudo-aneurysm secondary to femoral osteochondroma: a case report and literature review

Davies, Robert; Satti, Uzma; Duffield, R. G. M.

doi:10.1308/147870807x188461

Cited by 26 publications

(15 citation statements)

References 21 publications

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“…1, Most published articles on this subject are case reports, 1, and their management is not well codified. Some literature reviews were conducted, [3][4][5][6][7][8]12,16,28,33,37,40,42,44,49 but no update with robust data has been published. In most cases, the reviewed data are limited to the summarization of cases previously published.…”

Section: Introductionmentioning

confidence: 99%

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Management of extremity arterial pseudoaneurysms associated with osteochondromas

Raherinantenaina¹,

Ratsimba²,

Rajaonanahary³

2016

Vascular

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Arterial pseudoaneurysms associated with osteochondromas are rare and most publications on this topic are case reports. The management of this double entity is not standardized. We wanted to update it. Literature searches on MEDLINE and EMBASE were performed using the keywords "artery pseudoaneurysm" and "osteochondroma". Patient demographics, clinical presentations, diagnostic and therapeutic modalities were reviewed. In sum, 101 cases were analyzed. Overall, young adults represented the majority of the affected population with a masculine preponderancy (86%). Painful swelling (51%) was the most commonly physical finding. Distal femur was the most common site of the osteochondroma (86%). Multiple hereditary exostosis was seldom reported (36%). Diagnostic confirmation was dominated by arteriography (55%). Popliteal artery (77%) was the most commonly injured vessel. The treatment was open surgery with vascular repair and optimal exostectomy. Arterial repair was performed with saphenous vein grafting (40%) or lateral suture (39%). Postoperative courses were often uneventful (97%). Arterial pseudoaneurysms resulted from osteochondromas were dominated by those involving the popliteal artery. The use of arteriography to confirm the diagnosis may be limited to the benefit of non-invasive radiological methods because endovascular treatment is not relevant in the setting of osteochondroma-induced arterial pseudoaneurysm.

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Section: Introductionmentioning

confidence: 99%

“…In most cases, the reviewed data are limited to the summarization of cases previously published. [4][5][6] The exact epidemiology of this double entity is not well known. This review aimed to summarize the current knowledge on diagnostic and therapeutic features of patients with extremity APAs associated with OCs.…”

Section: Introductionmentioning

confidence: 99%

Management of extremity arterial pseudoaneurysms associated with osteochondromas

Raherinantenaina¹,

Ratsimba²,

Rajaonanahary³

2016

Vascular

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“…We also searched the literature on Pubmed using terms "pseudoaneurysm "and "osteochondroma" and we could find 75 such articles (case reports) majority of which were related to unruptured aneurysms involving popliteal artery [8,9]. This case is an addition to the limited available literature on the diagnosis and management of ruptured aneurysm caused by osteochondroma.…”

Section: Discussionmentioning

confidence: 99%

Management of a Case of Ruptured Pseudoaneurysm and Stenosis of Femoral Artery Caused by Femoral Osteochondroma

Goyal

Sharma

Kalia

et al. 2015

JCDR

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A 21-year-old male patient presented with history of pain and paresthesia in right lower limb alongwith difficulty in walking. The patient was investigated and roentgenogram of right femur revealed presence of a bone tumor arising from posterior aspect as seen in lateral view [Table/ Fig-1].Magnetic resonance imaging (MRI) was also done and it revealed exostosis arising from femur with surrounding hematoma, without any evidence of infiltration into surrounding structures [Table/Fig2a,b].Computed tomography (CT) Angiogram although of valuable information was not done at this stage as the presence of a ruptured pseudoaneurysm was not suspected initially. Tumor was considered benign and surgical intervention in the form of excision of the tumor was planned. Spinal anesthesia was given and patient was turned in to prone position and a tourniquet was placed around upper thigh. Midline incision in the posterior aspect of lower part of right thigh was given and posterior thigh muscles were retracted to reach the tumor. Hematoma and clots were evacuated, injury to femoral artery was not suspected at that time, moreover presence of a hematoma had distorted the muscular planes and structure differentiation was difficult. Tumor was excised and sent for histopathology examination. There was no active bleeding, even after deflation of tourniquet, probably due to presence of a clot and or hypotension caused by anesthesia. After ensuring hemostasis and inserting a suction drain standard closure was done. The patient was well, without any complaints and there was minimal drainage therefore aBstRaCt We present a rare case of ruptured pseudoaneurysm of distal femoral artery due to osteochondroma in a 21-year-old male. The patient was initially treated for osteochondroma as ruptured pseudoaneurysm was not suspected. Diagnosis of ruptured pseudoaneurysm could only be made intraoperatively when rent in the femoral artery was found along with surrounding hematoma and obstruction in the distal femoral artery. Patient underwent multiple surgeries (resection of osteochondroma and femoro-popliteal bypass) and recovered well with palpable pulsations in the operated limb.drain was removed on second post-operative day. The patient again developed pain and swelling few days later at the operative site and was taken for re-exploration under combined epidural and spinal anesthesia. Re-exploration was done through the same incision and large hematoma along with clots were found, which were removed. After removal of the clots bleeding started from a rent in femoral artery (neck of pseudoaneurysm) it was at that time diagnosis of ruptured pseudoaneurysm was made. Proximal control on femoral artery stopped the bleeding and there was no back bleeding from the distal end. The distal segment of femoral artery/proximal popliteal artery was found completely obliterated with unhealthy vessel wall and surrounding tissues. Rent in the femoral artery was closed with polypropylene 6-0 sutures. As the soft tissues were unhealthy and there was inadequate norm...

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“…It originates from the growth plate and consists of medullary and cortical bone, surrounded by a hyaline cartilage cover (24,25) . It predominantly affects men and is solitary in 90% of cases (25) .…”

Section: Popliteal Artery Pseudoaneurysm Secondary To Tibial Osteochomentioning

confidence: 99%

Unusual lesions that distend the knee joint: pictorial essay

et al. 2016

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The high number of knee imaging exams at radiology clinics, together with the wide variety of knee disorders, calls for expanding the knowledge about the less common lesions seen in routine diagnostic practice. The purpose of this pictorial essay was to illustrate unusual lesions that distend the knee joint, selected by relevance and evaluated with multiple imaging modalities, including X-ray, computed tomography, and magnetic resonance imaging, as well as to perform a brief review of the literature.

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Popliteal artery pseudo-aneurysm secondary to femoral osteochondroma: a case report and literature review

Cited by 26 publications

References 21 publications

Management of extremity arterial pseudoaneurysms associated with osteochondromas

Management of extremity arterial pseudoaneurysms associated with osteochondromas

Management of a Case of Ruptured Pseudoaneurysm and Stenosis of Femoral Artery Caused by Femoral Osteochondroma

Unusual lesions that distend the knee joint: pictorial essay

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