Acute Limb Ischemia Secondary to an Occult Superficial Femoral Artery Pseudoaneurysm in a Patient of Multiple Osteochondromas: A Rare Surgical Conundrum

A 19-year-old male presented with complaints of sudden-onset pain and weakness of his left lower limb for the last 7 days. The affected limb felt cold and entirely lacked strength. On clinical examination, he had tachycardia with a poikilothermic, pulseless, pale, and paresthetic left lower limb. On systemic examination, he was found to have multiple, firm, nontender bony swellings in the bilateral lower limbs. He gave a history of being managed by an orthopedician for multiple bony growths (exostosis). A computed angiography identified a pseudoaneurysm of the distal superficial femoral artery (SFA) and a thrombotic occlusion of the infragenicular arteries. He underwent left SFA pseudoaneurysm excision and over-the-wire thrombectomy of left popliteal, posterior tibial, anterior tibial artery thrombectomy, with vein patch angioplasty repair of the left SFA. He has successfully resumed his routine life with palpable distal pulses in the treated limb.