Jornal Vascular Brasileiro
https://www.jvascbras.org/article/doi/10.1590/S1677-54492007000200014
Jornal Vascular Brasileiro
Case Report

Pseudo-aneurisma de artéria tibial posterior pós-tratamento de fratura de perna com fixador externo: relato de caso e revisão da literatura

Pseudoaneurysm of the posterior tibial artery after external fixation for leg fracture: case report and review of the literature

Domingos de Morais Filho; Ramzi Abdallah El Hosni Jr.; Carlos Alberto Morselli Diniz; Igor Schincariol Perozin; Juliana Palmeira Gonçalves; José Antônio Morselli Diniz

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Resumo

Este trabalho descreve um caso de pseudo-aneurisma da artéria tibial posterior devido ao uso de fixador externo para tratamento de fratura dos ossos da perna (técnica de Ilizarov), bem como as técnicas utilizadas para seu tratamento. A compressão guiada por ultra-som e a injeção de trombina guiada por ultra-som foram realizadas, sem sucesso. O tratamento definitivo do pseudo-aneurisma e reconstrução arterial foi conseguido através do tratamento cirúrgico clássico, usando enxerto interposto de veia safena magna homóloga invertida. As indicações, vantagens e desvantagens das técnicas de tratamento não invasivo (compressão guiada por ultra-som e injeção de trombina guiada por ultra-som) e as possíveis causas de sua incapacidade na obliteração do pseudo-aneurisma são discutidas. Também foi realizada a revisão de casos de pseudo-aneurisma da artéria tibial posterior na literatura médica, encontrando-se apenas um caso semelhante, entre 24 publicados.

Palavras-chave

Pseudo-aneurisma, artéria tibial posterior, compressão guiada por ultra-som, injeção de trombina guiada por ultra-som, ultra-som vascular, duplex ultra-som

Abstract

We describe a case of pseudoaneurysm in the posterior tibial artery following treatment for tibial and fibula fractures using external fixation (Ilizarov technique), as well as the techniques used for its treatment. Ultrasound-guided compression and ultrasound-guided thrombin injection were unsuccessfully performed. Definite treatment of pseudoaneurysm and arterial reconstruction was achieved through the traditional surgical treatment, using interposed graft of inverted homologous great saphenous vein. Indications, advantages and disadvantages of noninvasive treatment techniques (ultrasound-guided compression and ultrasound-guided thrombin injection) and the possible causes of their inability in obliterating the pseudoaneurysm are discussed. A literature review of pseudoaneurysms of the posterior tibial artery was also carried out, resulting in only one similar case out of 24 published cases.

Keywords

Pseudoaneurysm, posterior tibial artery, ultrasound-guided compression, ultrasound-guided thrombin injection, vascular ultrasound, duplex ultrasound

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