Endovascular embolization of posttraumatic arterial crural pseudoaneurysms in the young (clinical observations)

Abstract

Aim. To show the effectiveness of endovascular embolization of posttraumatic arterial tibial pseudoaneurysms in the young. Material and Methods. The results of examination and endovascular embolization of arterial posttraumatic pseudoaneusysms in a 14-year-old girl and a 25-year-old man are described. Results and Discussions. In the first case, a 14-year-old girl contracted a closed right tibial fracture in the middle third with dislodgement of the fragments on Feb 10, 2017. The patient underwent internal metal osteosynthesis on Feb 20, 2017. During the intervention, arterial bleeding occurred, which was stopped by massive suturing of the tissues. On March 1, 2017 the child developed a tense formation in the popliteal fossa and shin edema. Posttraumatic pseudoaneurysm of the tibioperonal trunk was confirmed with Doppler investigation. The artery was embolized, and surgical drainage of the popliteal hematoma was performed. In the second case, a 25-year-old man acquired an open left tibial trauma on Nov 27, 2016 with fracture of both bones in the middle third and fragment dislodgement, followed by the Ilizarov apparatus osteosynthesis. On Feb 2, 2017, a tense formation emerged on the posterior surface of the shin. Dopplerography diagnosed pseudoaneurysm of the posterior tibial artery. The latter was embolized. In both cases the arterial posttraumatic pseudoaneurysms were obliterated with sufficient blood supply of the foot via the anterior tibial artery. Conclusions. Endovascular embolization is an effective method for treatment of posttraumatic arterial tibial pseudoaneurysms.

Keywords

• posttraumatic arterial pseudoaneurysm, tibioperonal trunk, posterior tibial artery, anterior tibial artery, arterial embolization