Figure 2: Intraoperative arteriogram demonstrating the pseudoaneurysm of the left posterior tibial artery (arrow)

Mentions: The patient was taken to the operating room. The left femoral artery was accessed in an antegrade fashion and an arteriogram confirmed a pseudoaneurysm in the mid-tibioperoneal trunk [Figure 2]. A 5 × 16 × 120 mm covered balloon-expandable iCast stent (Atrium Medical Corporation, Hudson, NH) was deployed from the proximal tibioperoneal trunk to the PT artery excluding the peroneal artery. Completion arteriography demonstrated no further extravasation and patent two-vessel runoff. The calf hematoma was evacuated. Aspirin and clopidogrel therapy were initiated, and the patient was discharged without event.

Marks JA, Hager E, Henry D, Martin ND - J Emerg Trauma Shock (2011)

Bottom Line: Due to the relative youth of this technology, studies have yet to be concluded on the long-term patency of stent grafts in this population.For this reason, concern exists with endovascular stent placement in the young trauma patient.In this study, we present a case and review the literature on a post-traumatic pseudoaneurysm of the posterior tibial artery in a 19-year-old man treated with an endovascular stent.

Affiliation: Department of Surgery, Division of Acute Care Surgery, Thomas Jefferson University, Philadelphia, PA, USA.

Abstract: Endovascular treatment of post-traumatic pseudoaneurysms has become a viable, less invasive option when compared to open repair. Due to the relative youth of this technology, studies have yet to be concluded on the long-term patency of stent grafts in this population. For this reason, concern exists with endovascular stent placement in the young trauma patient. In this study, we present a case and review the literature on a post-traumatic pseudoaneurysm of the posterior tibial artery in a 19-year-old man treated with an endovascular stent.