Pseudoaneurysm of Anterior Tibial Artery after Occlusion from Blunt Trauma

The angiographic finding of occluded isolated tibial artery after blunt trauma to the leg generally is ignored. A case of pseudoaneurysm and arteriovenous fistula that evolved from an occluded anterior tibial artery is presented. The pathology was treated successfully by percutaneous transfemoral placement of Gianturco coils in the tibial artery proximal and distal to the aneurysm. The nonsurgical approach in this patient avoided the risks of anesthesia, blood loss associated with a surgical procedure, the dilemma of the surgical approach in the presence of medial and lateral fasciotomy wounds, and of contamination and destabilization of the comminuted tibia-fibular fractures. This report raises the question of the proper management and followup procedures of occlusions of noncritical arteries found on angiography immediately after trauma.