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胫后动脉假性动脉瘤:骨科手术后罕见的并发症——病例报告

Posterior tibial artery pseudoaneurysm: a rare complication following orthopedic surgery-a case report.

作者信息

Bodart Estelle

机构信息

Department of Thoracic and Vascular Surgery, Clinique Saint-Pierre, Ottignies 1340, Belgium.

出版信息

J Surg Case Rep. 2025 May 7;2025(5):rjaf288. doi: 10.1093/jscr/rjaf288. eCollection 2025 May.

Abstract

Orthopedic procedures, although commonly associated with complications such as joint infections, deep venous thrombosis, or wound infections, rarely result in vascular complications. We present a case of a posterior tibial artery (PTA) pseudoaneurysm following blunt trauma during an elective orthopedic procedure involving the removal of osteosynthesis material. The patient developed leg swelling and intermittent hemorrhage between 1 and 3 weeks postoperatively. Doppler ultrasonography and contrast-enhanced computed tomography (CT) angiography confirmed the presence of a PTA pseudoaneurysm. The patient subsequently underwent open surgical repair in our secondary center, which involved exclusion of the pseudoaneurysm at the proximal PTA and patch angioplasty using an autologous venous graft. This case highlights the critical role of non-invasive diagnostic modalities, such as Doppler ultrasonography and contrast-enhanced CT with 3D reconstruction, in diagnosing vascular complications following orthopedic procedures. The patient remained asymptomatic during both the 3-week and 3-month follow-up periods.

摘要

骨科手术虽然通常与诸如关节感染、深静脉血栓形成或伤口感染等并发症相关,但很少导致血管并发症。我们报告一例在涉及取出内固定材料的择期骨科手术期间钝性创伤后发生的胫后动脉(PTA)假性动脉瘤病例。患者在术后1至3周出现腿部肿胀和间歇性出血。多普勒超声检查和增强计算机断层扫描(CT)血管造影证实存在PTA假性动脉瘤。该患者随后在我们的二级中心接受了开放手术修复,手术包括在PTA近端排除假性动脉瘤并使用自体静脉移植物进行补片血管成形术。本病例强调了诸如多普勒超声检查和具有三维重建功能的增强CT等非侵入性诊断方法在诊断骨科手术后血管并发症中的关键作用。在3周和3个月的随访期内,患者均无症状。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0ec2/12057733/cb3ee6a854a4/rjaf288f1.jpg

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