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Transarterial coil embolization of a symptomatic posttraumatic plantar pseudoaneurysm.

Beyer LP, Wohlgemuth WA, Müller-Wille R - Case Rep Radiol (2015)

Bottom Line: Posttraumatic pseudoaneurysms of the lateral plantar artery are rare.We report the case of a 31-year-old woman with a painful pseudoaneurysm of the lateral plantar artery resulting from a deep plantar cut injury.The pseudoaneurysm was successfully treated by performing a transarterial "frontdoor-backdoor" coil embolization technique, which is a minimally invasive alternative to conventional ligature of the artery.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, University Medical Center Regensburg, Franz-Josef-Strauß-Allee 11, 93042 Regensburg, Germany.

ABSTRACT
Posttraumatic pseudoaneurysms of the lateral plantar artery are rare. We report the case of a 31-year-old woman with a painful pseudoaneurysm of the lateral plantar artery resulting from a deep plantar cut injury. The pseudoaneurysm was successfully treated by performing a transarterial "frontdoor-backdoor" coil embolization technique, which is a minimally invasive alternative to conventional ligature of the artery.

No MeSH data available.


Related in: MedlinePlus

Frontdoor ((a) and (b)) and backdoor ((c) and (d)) coil embolization of the pseudoaneurysm with microcoils (white arrows). Angiography was performed through the 4-Fr catheter in the popliteal artery (a), respectively, the microcatheter in the lateral plantar artery (b) and plantar arch (c). The left lateral plantar artery was catheterized via the posterior tibial artery and the deep plantar arch via the dorsalis pedis artery (approached through the anterior tibial artery). DPA = dorsalis pedis artery. PA = plantar arch. LPA = lateral plantar artery.
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fig3: Frontdoor ((a) and (b)) and backdoor ((c) and (d)) coil embolization of the pseudoaneurysm with microcoils (white arrows). Angiography was performed through the 4-Fr catheter in the popliteal artery (a), respectively, the microcatheter in the lateral plantar artery (b) and plantar arch (c). The left lateral plantar artery was catheterized via the posterior tibial artery and the deep plantar arch via the dorsalis pedis artery (approached through the anterior tibial artery). DPA = dorsalis pedis artery. PA = plantar arch. LPA = lateral plantar artery.

Mentions: Arterial access was obtained by an antegrade puncture of the left common femoral artery using a 5-Fr sheath (Radifocus Introducer II, Terumo Corporation, Tokyo, Japan). A 4-Fr diagnostic catheter (Glidecath, Terumo, Tokyo, Japan) was placed in the P3 segment of the popliteal artery. The diagnostic angiography confirmed the MRA scan findings and demonstrated a pseudoaneurysm of the lateral plantar artery shortly before the transition to the deep plantar arch (Figure 2). Due to strong collateral circulation from the dorsalis pedis artery to the deep plantar arch we decided to secure the aneurysm using a “frontdoor-backdoor” coil embolization technique. After selective catheterization of the left lateral plantar artery via the posterior tibial artery using a microcatheter (Excelsior 10, Boston Scientific, Fremont, CA, USA) and a microwire (Synchro 10, Stryker Neurovascular, Fremont, CA, USA) the vessel was occluded with two electrolytically detachable microcoils (MicroPlex 10, 3 mm/8 cm and 2 mm/8 cm, MicroVention Inc., Aliso Viejo, CA) in proximity to the pseudoaneurysm (Figure 3). This was followed by a selective catheterization of the deep plantar arch via the dorsalis pedis artery (approached through the anterior tibial artery) and placement of two more microcoils (MicroPlex 10, 2 mm/6 cm and 2 mm/8 cm, MicroVention Inc., Aliso Viejo, CA) distal to the pseudoaneurysm. The final angiography demonstrated a complete elimination of the pseudoaneurysm (Figure 4) and the small arteriovenous fistula. All of the plantar metatarsal arteries showed a regular perfusion after the intervention.


Transarterial coil embolization of a symptomatic posttraumatic plantar pseudoaneurysm.

Beyer LP, Wohlgemuth WA, Müller-Wille R - Case Rep Radiol (2015)

Frontdoor ((a) and (b)) and backdoor ((c) and (d)) coil embolization of the pseudoaneurysm with microcoils (white arrows). Angiography was performed through the 4-Fr catheter in the popliteal artery (a), respectively, the microcatheter in the lateral plantar artery (b) and plantar arch (c). The left lateral plantar artery was catheterized via the posterior tibial artery and the deep plantar arch via the dorsalis pedis artery (approached through the anterior tibial artery). DPA = dorsalis pedis artery. PA = plantar arch. LPA = lateral plantar artery.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4383240&req=5

fig3: Frontdoor ((a) and (b)) and backdoor ((c) and (d)) coil embolization of the pseudoaneurysm with microcoils (white arrows). Angiography was performed through the 4-Fr catheter in the popliteal artery (a), respectively, the microcatheter in the lateral plantar artery (b) and plantar arch (c). The left lateral plantar artery was catheterized via the posterior tibial artery and the deep plantar arch via the dorsalis pedis artery (approached through the anterior tibial artery). DPA = dorsalis pedis artery. PA = plantar arch. LPA = lateral plantar artery.
Mentions: Arterial access was obtained by an antegrade puncture of the left common femoral artery using a 5-Fr sheath (Radifocus Introducer II, Terumo Corporation, Tokyo, Japan). A 4-Fr diagnostic catheter (Glidecath, Terumo, Tokyo, Japan) was placed in the P3 segment of the popliteal artery. The diagnostic angiography confirmed the MRA scan findings and demonstrated a pseudoaneurysm of the lateral plantar artery shortly before the transition to the deep plantar arch (Figure 2). Due to strong collateral circulation from the dorsalis pedis artery to the deep plantar arch we decided to secure the aneurysm using a “frontdoor-backdoor” coil embolization technique. After selective catheterization of the left lateral plantar artery via the posterior tibial artery using a microcatheter (Excelsior 10, Boston Scientific, Fremont, CA, USA) and a microwire (Synchro 10, Stryker Neurovascular, Fremont, CA, USA) the vessel was occluded with two electrolytically detachable microcoils (MicroPlex 10, 3 mm/8 cm and 2 mm/8 cm, MicroVention Inc., Aliso Viejo, CA) in proximity to the pseudoaneurysm (Figure 3). This was followed by a selective catheterization of the deep plantar arch via the dorsalis pedis artery (approached through the anterior tibial artery) and placement of two more microcoils (MicroPlex 10, 2 mm/6 cm and 2 mm/8 cm, MicroVention Inc., Aliso Viejo, CA) distal to the pseudoaneurysm. The final angiography demonstrated a complete elimination of the pseudoaneurysm (Figure 4) and the small arteriovenous fistula. All of the plantar metatarsal arteries showed a regular perfusion after the intervention.

Bottom Line: Posttraumatic pseudoaneurysms of the lateral plantar artery are rare.We report the case of a 31-year-old woman with a painful pseudoaneurysm of the lateral plantar artery resulting from a deep plantar cut injury.The pseudoaneurysm was successfully treated by performing a transarterial "frontdoor-backdoor" coil embolization technique, which is a minimally invasive alternative to conventional ligature of the artery.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, University Medical Center Regensburg, Franz-Josef-Strauß-Allee 11, 93042 Regensburg, Germany.

ABSTRACT
Posttraumatic pseudoaneurysms of the lateral plantar artery are rare. We report the case of a 31-year-old woman with a painful pseudoaneurysm of the lateral plantar artery resulting from a deep plantar cut injury. The pseudoaneurysm was successfully treated by performing a transarterial "frontdoor-backdoor" coil embolization technique, which is a minimally invasive alternative to conventional ligature of the artery.

No MeSH data available.


Related in: MedlinePlus