Ruptured Pseudo-aneurysm of the Popliteal Artery after Percutaneous Transluminal Angioplasty

Abstract

An 88-year-old female presented with gangrene of two toes of the left foot. Angiography revealed a calcified occlusion of the left popliteal artery, 8 cm in length. Recanalisation was performed and the occlusion was successfully dilated. On day 13 after the procedure, the patient experienced acute pain in the left popliteal fossa. Ultrasound revealed a large pseudo-aneurysm of the popliteal artery. Angiography not only confirmed this finding but showed rupture of this pseudo-aneurysm. An above-knee amputation was performed.

Pseudo-aneurysm formation at the site of previous PTA is considered as a rare complication and has not been reported in the literature. The incidence of pseudo-aneurysm formation at a PTA site is unknown because it is not routinely detected. Predisposing general and local factors are discussed. The present case illustrates that pseudo-aneurysms can cause other major complications with disastrous consequences for the patient.

Pseudo-aneurysms after previous PTA should be treated by conventional bypass surgery or by endovascular means. Further studies should be undertaken to evaluate the risk of pseudo-aneurysm formation after previous PTA and to define which patients should be monitored closely.

Additional information

Notes on contributors

A. Derom

A. Derom, M.D. Department of Surgery Hospital De Honte Wielingenlaan 2 4535 PA Terneuzen, The Netherlands Tel.: [phone] Fax: [phone]