Introduction. Increasing incidence of trauma all over the world will increase the risk of vascular trauma, so will the prevalence of pseudoaneurysm. Post traumatic pseudoaneurysm occurs within days or months and commonly diagnosed as hematoma in its early presentation. An effective, less invasive, and low-cost treatment with high rate of survival is needed by patients with post traumatic pseudoaneurysm. Endovascular surgery is one of the less invasive techniques. This case report was made to find out the effectivity of endovascular surgery in the treatment of post traumatic pseudoaneurysm.
Method. Literature searching was performed in Cochrane Library, EBSCOhost, ClinicalKey, Pubmed, dan Proquest database. Five articles were found to be relevant to the topic. There were only case report articles with level of evidence level 4 based on Oxford Centre for Evidence Based Medicine 2011.
Results. Endovascular surgery approach was effective in the treatment of post traumatic lower extremity pseudoaneurysm for those who were not eligible for open surgery or conservative technique. Patients were given long term dual antiplatelet therapy for 6-12 months. Within 6-18 months of follow up, the pseudoaneurysm was completely obliterated and the patients were symptoms free.
Conclusion. Based on level of evidence number 4 endovascular surgery approach can be used for post traumatic pseudoaneurysm patients who were not eligible for open surgery or conservative technique. Further research is needed to know the side effect and complication of endovascular surgery
1. Atta H, Tagoe A, Walker M. Delayed presentation of popliteal artery pseudoaneurysm following blunt trauma. Amr Surg. 1997;63(6):496–9.
2. Rosa P, O’Donnell SD, Goff JM, Gillespie DL, Starnes B. Endovascular Management of a Peroneal Artery Injury Due to a Military Fragment Wound. Ann Vasc Surg. 2003;17(6):678–81.
3. Sriussadaporn S. Arterial injuries of the lower extremity from blunt trauma. J Med Assoc Thai. 1997;80(2):121–9.
4. De Troia A, Biasi L, Iazzolino L, Azzarone M, Tecchio T, Rossi C, et al. Endovascular stent grafting of a posterior tibial artery pseudoaneurysm secondary to penetrating trauma: Case report and review of the literature. Ann Vasc Surg [Internet]. 2014;28(7):1789.e13-1789.e17. Available from: http://dx.doi.org/10.1016/j.avsg.2014.02.013
5. Marron CD, McKay D, Johnston R, McAteer E, Stirling WJI. Pseudo-aneurysm of the anterior tibial artery, a rare cause of ankle swelling following sports injury. BMC Emerg Med. 2005;5:1–4.
6. Ramavath AL, Cornish JA, Ganapathi M, Williams DT. Missed diagnosis of ankle pseudoaneurysm following ankle arthroscopy: A case report. Cases J. 2009;2(10):1–4.
7. Morgan R, Belli AM. Current treatment methods for postcatheterization pseudoaneurysms. J Vasc Interv Radiol. 2003;14(6):697–710.
8. Foster B, Anderson S, Soto J. CT angiography of extremity trauma. Tech vasc int radiol. 2006;9(4):156–66.
9. Pisharody S, Kannath S, Rajan J. Endovascular Stent Grafting in Posttraumatic Tibial Artery Pseudoaneurysms: Case Report. J Clin Interv Radiol. 2016;(1):61–4.
10. Jang EC, Kwak BK, Song KS, Jung HJ, Lee JS, Yang JJ. Pseudoaneurysm of the anterior tibial artery after ankle arthroscopy treated with ultrasound-guided compression therapy. A case report. J Bone Jt Surg - Ser A. 2008;90(10):2235–9.
11. Gratl A, Klocker J, Glodny B. Treatment options of crural pseudoaneurysms. Vasa. 2014;43(3):209–15.
12. Diagnosis PV. PERIPHERAL VASCULAR DIAGNOSIS AND INTERVENTIONS Pseudoaneurysms and the Role of Minimally Invasive Techniques in Their Management. 2005;173–90.
13. Wani ML, Ahangar AG, Wani SN, Dar AM, Ganie FA, Singh S, et al. Peripheral vascular injuries due to blunt trauma (road traffic accident): Management and outcome. Int J Surg [Internet]. 2012;10(9):560–2. Available from: http://dx.doi.org/10.1016/j.ijsu.2012.08.018
14. Skuder P, Gelfand M, Blumenberg R. Tibial artery false aneurysm: uncommon result of blunt injury occurring during athletics. Ann Vasc Surg. 1999;13(6):589–91.
15. Spirito R, Trabattoni P, Pompilio G, Zoli S, Agrifoglio M, Biglioli P. Endovascular treatment of a post-traumatic tibial pseudoaneurysm and arteriovenous fistula: Case report and review of the literature. J Vasc Surg. 2007;45(5):1076–9.
16. Joglar F, Kabutey NK, Maree A, Farber A. The role of stent grafts in the management of traumatic tibial artery pseudoaneurysms: Case report and review of the literature. Vasc Endovascular Surg. 2010;44(5):407–9.
17. Marks A, Haeger E, Hendry D, Martin N. Lower extremity vascular stenting for a post-traumatic pseudoaneurysm in a young trauma patient. Vasc Endovascular Surg. 2010;44(5):407–9.
18. Jones A, Kumar S. Successful Stenting of Iatrogenic Anterior Tibial Artery Pseudoaneurysm. EJVES Short Reports [Internet]. 2016;30:4–6. Available from: http://dx.doi.org/10.1016/j.ejvssr.2015.12.003
19. Darius Aw KL, Tan CC, Ch’ng JK, Chng SP. A case report of an anterior tibial artery pseudo-aneurysm open surgical management: A rare complication post total knee arthroplasty. Int J Surg Case Rep [Internet]. 2017;37:196–9. Available from: http://dx.doi.org/10.1016/j.ijscr.2017.06.037
20. Amiri F, Sandford Z, Constantinou C. Traumatic Posterior Tibial Pseudoaneursym: A rare late complication repaired conventionally. Marshall J Med. 2016;2(3).
Darwis, Patrianef and Subrata, Feyona H.
"Endovascular Management of Post Traumatic Lower Extremity Pseudoaneurysm: An Evidence Based Case Report,"
The New Ropanasuri Journal of Surgery: Vol. 5
, Article 10.
Available at: https://scholarhub.ui.ac.id/nrjs/vol5/iss1/10