Peroneal artery pseudoaneurysm – a case report and literature review

This report describes an unusual case of peroneal pseudoaneurysm developing after thromoboembolectomy with a Fogarty catheter. It was managed successfully using an endovascular technique consisting of selective catheterization and coil embolization. The coils were placed in the peroneal artery, both proximal and distal to the pseudoaneurysm.Endovascular technique can be successfully used to treat pseudoaneurysms in difficult settings.Pseudoaneurysms of the peroneal arteries being uncommon offer interesting management strategies [1] . An interesting case is presented and its management discussed below.A 68-year-old gentleman presented to the emergency department 2 weeks after thromboembolectomy for an acutely ischemic leg, with complaints of pain in the lower part of the right leg, both at rest and on walking. He was an ex-smoker with a history of multiple aneurysm repairs namely repair of a ruptured right common iliac aneurysm (2001), repair of a tender 4.5 cm left common femoral aneurysm (2005) and embolisation of a 3.9 cm left internal iliac aneurysm through a right common femoral access (2006). Just after the embolisation, he developed an acutely ischemic right leg, for which he underwent a successful thromoboembolectomy through a femoral arteriotomy. Embolectomy was performed using a size 2–3 Fogarty Embolectomy catheter. Fresh thrombus was retrieved and blood flow resumed with restoration of pre-event distal pulses.The patient presented with right leg pain 2 weeks following embolectomy. On admission he had a pulse rate of 80 beats per minute and was normotensive. There was no apparent leg swelling, no visible sign of ischemia or injury to the leg. Dorsalis pedis pulse was not palpable though good posterior tibial and popliteal pulses were present. An expansile swelling was palpable on the anteromedial surface of the leg, 5 cm above the ankle.A colour Doppler ultrasound of the leg suggested the presence of a peroneal pseudoaneurysm. Digital subtraction angiograp