Posttraumatic pseudoaneurysm of medial plantar artery in a child: treatment with percutaneous thrombin injection

Fabrício Neto Ladeira,Leandro Toledo Carvalhido,Luciano Santa Bárbara De Abreu,Francisco Lopes Pereira,Paula Cardoso Diniz,Liege Costa De Avelar Rezende,Antônio Henrique De Souza Quintella

doi:10.1590/jvb.2014.009

Abstract

Pseudoaneurysms of the medial plantar artery are rare. The authors describe a case of a pseudoaneurysm of the medial plantar artery of a child who had suffered a penetrating laceration injury. Diagnosis can be confirmed using Doppler ultrasound and magnetic resonance angiography. As an alternative to the conventional surgery technique, percutaneous Doppler ultrasound-guided thrombin injection is a safe and effective treatment.

Highlights

Pseudoaneurysms are aneurysms whose walls are not comprised of the vessel’s own parietal structures, which is what differentiates them from true aneurysms
The clot that forms in the periphery of the hematoma tends to organize and, in conjunction with the cicatricial reaction of adjacent tissues, will form the walls of the aneurysm sac which, in turn, does not have the elements that are characteristic of the artery wall.[1,2]
In this paper we report on the case of a medial plantar artery pseudoaneurysm secondary to a penetrating laceration trauma in a child

Summary

INTRODUCTION

Pseudoaneurysms are aneurysms whose walls are not comprised of the vessel’s own parietal structures, which is what differentiates them from true aneurysms They are very often the result of a communication with an artery after direct trauma, in which the lumen remains in contact with the pulsating hematoma, causing it to rupture. Magnetic resonance angiography of the right foot showed a pseudoaneurysm with a rounded shape, regular outline and well-defined limits located in the plantar region, between the abductor muscles of the fifth toe and the short flexor of the toes. Tendons and ligaments were spared (Figure 1) These findings were corroborated by a Doppler ultrasound, which, in addition to the anatomic details, showed the dynamics of the medial plantar artery pseudoaneurysm (Figure 2). The patient was already able to walk with no limitations on the third day after treatment and was free from complications or relapse at 8 months’ follow-up (Figure 4)

DISCUSSION

CONCLUSIONS