Table of Contents  
CASE REPORT
Year : 2016  |  Volume : 3  |  Issue : 4  |  Page : 145-146

Foot Aneurysms


1 Department of Vascular Surgery, Mount Multispeciality Hospitals, Chennai, Tamil Nadu, India
2 Department of General Medicine, Mount Multispeciality Hospitals, Chennai, Tamil Nadu, India

Date of Web Publication30-Sep-2016

Correspondence Address:
Saravanan Balachandran
Department of Vascular Surgery, Mount Multispeciality Hospitals, Chennai, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0972-0820.191504

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  Abstract 

Aneurysm of the foot is rare. These aneurysms are diagnosed based on clinical examination and angiogram. The treatment protocol was based on the angiogram, and the culture examination of the specimen will definitely have a role to play in the overall management of the patient.

Keywords: Aneurysm, angiogram, bypass, culture examination, dorsalis pedis artery


How to cite this article:
Balachandran S, Rajkumar M, Subrammaniyam S R, Suganya M. Foot Aneurysms. Indian J Vasc Endovasc Surg 2016;3:145-6

How to cite this URL:
Balachandran S, Rajkumar M, Subrammaniyam S R, Suganya M. Foot Aneurysms. Indian J Vasc Endovasc Surg [serial online] 2016 [cited 2020 Sep 28];3:145-6. Available from: http://www.indjvascsurg.org/text.asp?2016/3/4/145/191504


  Introduction Top


Aneurysm of the dorsalis pedis artery is rare, and very few cases have been reported in the literature. We report the management of a mycotic peripheral aneurysm.


  Case Report Top


A 63-year-old female was referred for foot pain with suspected aneurysmal swelling in the foot. On clinically evaluating, the patient is a known diabetic and hypertensive on medications. She noticed the swelling for the past 6 months with a minimal increase in size for the past 6 months. The patient denies history of trauma [1] or any other intervention to the foot.

On examination, the pulsatile swelling [Figure 1] was approximately 2.5 cm × 1.8 cm in size over the dorsal aspect of foot which is tender to touch. Clinically, the swelling was diagnosed as dorsalis pedis artery aneurysm; hence, after routine blood investigation including surgical profile, she was subjected to angiogram [Figure 2] to confirm the diagnosis, to determine the blood flow to the extremities, and to rule out other peripheral aneurysms. [2]
Figure 1: Dorsalis pedis artery aneurysm

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Figure 2: Angiogram

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Based on the angiogram, the patient was subjected to excision of aneurysm [Figure 3] with primary repair [3],[4] [Figure 4] of the artery. Postoperative period was uneventful with palpable distal pulses; further, digital flow was confirmed with hand Doppler examination. The specimen was subjected to pathological studies and for culture examination.
Figure 3: Intraoperative image

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Figure 4: Picture after primary repair

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The culture [5] was positive for salmonella hence was treated with antibiotics accordingly.


  Discussion Top


Aneurysm of the dorsalis pedis artery is rare, and very few cases have been reported in the literature. These aneurysms have vague presentation with pain, neurological compressive symptoms, or very rarely ischemic pain [6] over the extremities. The patients usually present with dorsalis pedis artery aneurysm after trauma [7] or after any surgical intervention in the foot or after an IV access.

The treatment protocol is based after confirming the diagnosis by clinical examination, Duplex studies, and angiogram. Various treatment options are available for the reconstruction of the artery in the form of primary repair or bypass or by ligation of the artery.

This patient has undergone primary repair considering the atherosclerotic nature, and there is a possibility of future distal ischemia to the toes. In addition, painful aneurysms necessitated the need to intervene in a case of dorsalis pedis artery aneurysm. The specimen was subjected to culture examination to treat the underlying bacteremia which could be one of the etiological factors.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
McKee TI, Fisher JB. Dorsalis pedis artery aneurysm: Case report and literature review. J Vasc Surg 2000;31:589-91.  Back to cited text no. 1
[PUBMED]    
2.
Al-Omran M. Repair of a true dorsalis pedis artery saccular aneurysm. J Surg Case Rep 2012;2012:15.  Back to cited text no. 2
    
3.
Legal K. Dorsalis Pedis Aneurysm: A Case Report and Review of the Literature. The Foot & Ankle Journal 2008:1. Available from: http://doi.org/10.3827/faoj.2008.0111.0001 [Last accessed on 2016 Aug 24].  Back to cited text no. 3
    
4.
Kato T, Takagi H, Sekino S, Manabe H, Matsuno Y, Furuhashi K, et al. Dorsalis pedis artery true aneurysm due to atherosclerosis: Case report and literature review. J Vasc Surg 2004;40:1044-8.  Back to cited text no. 4
[PUBMED]    
5.
Nishi H, Miyamoto S, Minamimura H, Ishikawa T, Katoh Y, Shimizu Y. Pseudoaneurysm of the dorsalis pedis artery causing neurological deficit. Ann Vasc Surg 2004;18:487-9.  Back to cited text no. 5
[PUBMED]    
6.
Tempest HV, Wilson YG. Acute forefoot ischaemia: An unreported complication of dorsalis pedis artery aneurysm. Eur J Vasc Endovasc Surg 2001;22:472-3.  Back to cited text no. 6
[PUBMED]    
7.
Yamaguchi S, Mii S, Yonemitsu Y, Orita H, Sakata H. A traumatic pseudoaneurysm of the dorsalis pedis artery: Report of a case. Surg Today 2002;32:756-7.  Back to cited text no. 7
[PUBMED]    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4]



 

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   Abstract
  Introduction
  Case Report
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   References
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