Cerebral Mycotic Aneurysm and Infective Endocarditis: A Case Study

2018 ◽  
Vol 42 (2) ◽  
pp. 71-73
Author(s):  
Leslie Wormely ◽  
Arrin Williams ◽  
Sashi Kilaru
Keyword(s):  
Aortic Valve ◽  
Artery Aneurysm ◽  
Peroneal Artery ◽  
Anterior Tibial Artery ◽  
Tibial Artery ◽  
Prosthetic Aortic Valve ◽  
Anterior Tibial ◽  
Mycotic Aneurysms ◽  
The Right

Mycotic aneurysms resulting from endocarditis are uncommon, and patients having aneurysms in multiple locations are rare. We report on a case of a patient having both infrapopliteal and cerebral mycotic aneurysms as a result of endocarditis. A patient was referred to the vascular lab for a lower extremity venous duplex, which incidentally demonstrated an infrapopliteal aneurysm of the right tibio-peroneal trunk. Computed tomography (CT) demonstrated two separate aneurysms: one at the origin of the anterior tibial artery and another involving the peroneal artery. The anterior tibial artery aneurysm was treated surgically. A transesophageal echocardiogram was performed on the patient and identified vegetation on the prosthetic aortic valve. The patient was then transferred to another facility for replacement of the prosthetic aortic valve. The patient suffered a cerebrovascular accident (CVA) postoperatively and subsequently had two cerebral mycotic aneurysms identified and treated.

Aneurysm of the anterior tibial artery as a complication of infectious endocarditis

Vascular ◽  
2020 ◽  
pp. 170853812096946
Author(s):  
Samantha L Terranella ◽  
Rebecca A Deal ◽  
Erin C Farlow ◽  
Richard R Keen ◽  
Neha Sheng
Keyword(s):  
Infective Endocarditis ◽  
Surgical Repair ◽  
Primary Repair ◽  
Management Strategies ◽  
Anterior Tibial Artery ◽  
Open Surgical Repair ◽  
Tibial Artery ◽  
Anterior Tibial ◽  
Mycotic Aneurysms

Objective Mycotic aneurysms of the infrapopliteal vessels are rare, with few cases reported in the literature. Management strategies are diverse and should be tailored to the patient’s presentation. Methods We describe the case of a 40-year-old male who presented with a painful left leg mass in the setting of bacteremia and infective endocarditis. Imaging revealed an aneurysm of the anterior tibial artery. Results The patient was treated with antibiotics and open surgical repair with excision of the aneurysmal sac, ligation of the anterior tibial artery, and primary repair of the popliteal artery and tibioperoneal trunk. Conclusion The epidemiology, pathophysiology, and clinical management of infrapopliteal aneurysms are briefly reviewed in this case study.

scholarly journals Surgical Treatment for Right Anterior Tibial Artery Aneurysm

2015 ◽  
Vol 55 (3) ◽  
pp. 43-46 ◽  
Author(s):  
Masafumi Kudo ◽  
Kozo Kaneda ◽  
Shinya Yokoyama ◽  
Shigeo Nagasaka ◽  
Tomofumi Taki ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Artery Aneurysm ◽  
Anterior Tibial Artery ◽  
Tibial Artery ◽  
Anterior Tibial

True Anterior Tibial Artery Aneurysm in a Runner

2014 ◽  
Vol 80 (11) ◽  
pp. 298-299 ◽  
Author(s):  
Scott Michael John ◽  
Michael S. Greer
Keyword(s):  
Artery Aneurysm ◽  
Anterior Tibial Artery ◽  
Tibial Artery ◽  
Anterior Tibial

scholarly journals Ultrasound in diagnosis of anatomical variation of anterior and posterior tibial arteries.

2016 ◽  
Vol 18 (1) ◽  
pp. 64 ◽  
Author(s):  
Miao Zheng ◽  
Chuang Chen ◽  
Qianyi Qiu ◽  
Changjun Wu
Keyword(s):  
Anatomical Variation ◽  
Posterior Tibial Artery ◽  
Peroneal Artery ◽  
Medial Malleolus ◽  
Anterior Tibial Artery ◽  
Tarsal Tunnel ◽  
Posterior Tibial ◽  
Tibial Artery ◽  
Tibial Arteries ◽  
Anterior Tibial

Aims: Knowledge about branching pattern of the popliteal artery is very important in any clinical settings involving the anterior and posterior tibial arteries. This study aims to elucidate the anatomical variation patterns and common types of anterior tibial artery (ATA) and posterior tibial arteries (PTA) in the general population in China. Material and methods: Anatomical variations of ATA, PTA, and peroneal artery were evaluated with ultrasound in a total of 942 lower extremity arteries in 471 patients. Results: Three patterns of course in the PTA were ultrasonographically identified:  1) PTA1: normal anatomy with posterior tibial artery entering tarsal tunnel to perfuse the foot (91.5%),  2) PTA2: tibial artery agenetic, and replaced by communicating branches of peroneal artery entering tarsal tunnel above the medial malleolus to perfuse the foot (5.9%), and 3) PTA3: hypoplastic or aplastic posterior tibial artery communicating above the medial malleolus with thick branches of peroneal artery to form a common trunk entering into the tarsal tunnel (2.4%). In cases where ATA  was hypoplastic or aplastic, thick branches of the peroneal artery replaced the anterior tibial artery to give rise to dorsalis pedis artery, with a total incidence of 3.2 % in patients, and were observed more commonly in females than in males. Hypoplastic or aplastic termini of ATA and PTA, with perfusion of the foot solely by the peroneal artery, was identified in 1 case. In another case, both communicating branches of the peroneal artery and PTA entered the tarsal tunnel to form lateral and medial plantar arteries.Conclusions: Anatomical variation of ATA and PTA is relatively common in the normal population. Caution should be exercised with these variations when preparing a peroneal artery vascular pedicle flap grafting. Ultrasound evaluation provides accurate and reliable information on the variations.

scholarly journals Pseudoaneurysm of the Perforating Peroneal Artery following Ankle Arthroscopy

2018 ◽  
Vol 2018 ◽  
pp. 1-6
Author(s):  
Ichiro Tonogai ◽  
Eiki Fujimoto ◽  
Koichi Sairyo
Keyword(s):  
Ankle Joint ◽  
Vascular Complications ◽  
Posterior Tibial Artery ◽  
Ankle Arthroscopy ◽  
Peroneal Artery ◽  
Anterior Tibial Artery ◽  
Foot And Ankle ◽  
Posterior Tibial ◽  
Tibial Artery ◽  
Anterior Tibial

The use of standard anterolateral and anteromedial portals in ankle arthroscopy results in reduced risk of vascular complications. Anatomical variations of the arterial network of the foot and ankle might render the vessels more susceptible to injury during procedures involving the anterior ankle joint. The literature, to our knowledge, reports only one case of a pseudoaneurysm involving the peroneal artery after ankle arthroscopy. Here, we report the unusual case of a 48-year-old man in general good health with the absence of the anterior tibial artery and posterior tibial artery. The patient presented with a pseudoaneurysm of the perforating peroneal artery following ankle arthroscopy for traumatic osteoarthritis associated with nonunion of the medial malleolus. The perforating peroneal artery injury was repaired by performing end-to-end anastomosis. The perforating peroneal artery is at higher risk for iatrogenic injury during ankle arthroscopy in the presence of abnormal arterial variations of the foot and ankle, particularly the absence of the anterior tibial artery and posterior tibial artery. Before ankle arthroscopy, surgeons should therefore carefully observe the course of the perforating peroneal artery on enhanced 3-dimensional computed tomography, especially in patients with a history of trauma to the ankle joint.

scholarly journals Aneurysmectomy and Revascularization of Anterior Tibial Artery Aneurysm: Case Report

2019 ◽  
Vol 12 (4) ◽  
pp. 548-550 ◽  
Author(s):  
Noriaki Sato ◽  
Kaori Kato ◽  
Masaru Takekubo ◽  
Shinya Mimura ◽  
Osamu Namura ◽  
...  
Keyword(s):  
Case Report ◽  
Artery Aneurysm ◽  
Anterior Tibial Artery ◽  
Tibial Artery ◽  
Anterior Tibial

scholarly journals Vascular affection in relation to oxidative DNA damage in metabolic syndrome

2018 ◽  
Vol 9 (2) ◽  
pp. 43-51 ◽  
Author(s):  
Rokayaa Abd El Aziz ◽  
Mary Wadie Fawzy ◽  
Noha Khalil ◽  
Sahar Abdel Atty ◽  
Zainab Sabra
Keyword(s):  
Metabolic Syndrome ◽  
Total Cholesterol ◽  
Blood Sugar ◽  
Ankle Brachial Index ◽  
Anterior Tibial Artery ◽  
Obese Patients ◽  
Tibial Artery ◽  
Significant Difference ◽  
Anterior Tibial ◽  
The Right

Introduction: Obesity has become an important issue affecting both males and females. Obesity is now regarded as an independent risk factor for atherosclerosis-related diseases. Metabolic syndrome is associated with increased risk for development of cardiovascular disease. Urinary 8-oxo-7,8-dihydro-2′-deoxyguanosine concentration has been used to express oxidation status. Methods: Twenty-seven obese patients with metabolic syndrome, 25 obese patients without metabolic syndrome and 31 healthy subjects were included in our study. They were subjected to full history and clinical examination; fasting blood sugar (FBS), 2 hour post prandial blood sugar (2HPP), lipid profile, urinary 8-oxo-7,8-dihydro-2′-deoxyguanosine and carotid duplex, A/B index and tibial diameters were all assessed. Results: There was a statistically significant difference ( p = 0.027) in diameter of the right anterior tibial artery among the studied groups, with decreased diameter of the right anterior tibial artery in obese patients with metabolic syndrome compared to those without metabolic syndrome; the ankle brachial index revealed a lower index in obese patients with metabolic syndrome compared to those without metabolic syndrome. There was a statistically insignificant difference ( p = 0.668) in the 8-oxodG in the studied groups. In obese patients with metabolic syndrome there was a positive correlation between 8-oxodG and total cholesterol and LDL. Conclusion: Urinary 8-oxodG is correlated to total cholesterol and LDL in obese patients with metabolic syndrome; signifying its role in the mechanism of dyslipidemia in those patients. Our study highlights the importance of anterior tibial artery diameter measurement and ankle brachial index as an early marker of atherosclerosis, and how it may be an earlier marker than carotid intima-media thickness.

Quantitative and Qualitative Assessment of the Relative Arterial Contributions to the Calcaneus

2018 ◽  
Vol 39 (5) ◽  
pp. 604-612 ◽  
Author(s):  
Johanna C. E. Donders ◽  
Craig E. Klinger ◽  
Andre D. Shaffer ◽  
Lionel E. Lazaro ◽  
Ryan R. Thacher ◽  
...  
Keyword(s):  
Posterior Tibial Artery ◽  
Quantitative Mri ◽  
Peroneal Artery ◽  
Anterior Tibial Artery ◽  
Soft Tissue Envelope ◽  
Posterior Tibial ◽  
Tibial Artery ◽  
Contrast Enhanced ◽  
Entry Points ◽  
Anterior Tibial

Background: The purpose of this study was to quantitatively and qualitatively assess relative arterial contributions to the calcaneus. Method: Fourteen cadaveric ankle pairs were used. In each specimen, the posterior tibial artery, peroneal artery, and anterior tibial artery were cannulated and used for contrast-enhanced magnetic resonance imaging (MRI) and computed tomography (CT). Quantitative MRI analysis of the pre- and postcontrast MRI scans facilitated assessment of relative arterial contributions. In addition, postcontrast MRIs were used to measure all perfused arterial entry points and scaled to a 3-dimensional calcaneus model. Contrast-enhanced CT imaging was assessed to further delineate the extraosseous arterial course. Two pairs underwent infusion of diluted BaSO4 through a constant-pressure pump using extended infusion duration. Results: Quantitative MRI findings indicated the peroneal artery provided 52.6% of the calcaneal arterial supply, 31.6% from the posterior tibial artery, and 15.8% from the anterior tibial artery. The cortical entry points were found in fairly consistent patterns along calcaneal cortical surfaces. All specimens demonstrated intraosseous anastomoses between lateral and medial entry points at common locations. Conclusions: The peroneal artery was found to provide the largest calcaneal arterial contribution, followed by the posterior tibial artery and anterior tibial artery. A rich anastomotic arterial network was found supplying the calcaneus. Clinical Relevance: This study provides quantitative and qualitative findings of the relative arterial contribution of the calcaneus. This knowledge can help expand our understanding of calcaneal vascularization, demonstrate the vascular impact of calcaneal fracture and surgery, and facilitate future research on the arterial anatomy of the calcaneal soft tissue envelope.

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