PMC6617909_01
Preoperative reconstructed computed tomography angiography of the tibial arteries bilaterally, demonstrating abrupt occlusion of the left posterior tibial artery and a right-sided posterior tibial artery aneurysm. Please note that artefact from bilateral knee prostheses obstructs visualising normal flow within the popliteal arteries in this image.
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Dominant flow to the foot was via the PTA, which occluded in the distal calf (Figure 1).
Angiography of the left posterior tibial artery aneurysm after thrombectomy.
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A PTA thrombectomy was performed and subsequent angiography demonstrated flow to the foot via the aneurysmal PTA (Figure 2).
Intraoperative images demonstrating exposure of the posterior tibial artery aneurysm (a) and containing intramural thrombus (b).
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The aneurysm was opened and demonstrated a mixture of old, organised, and fresh thrombus (Figure 3).
Postoperative angiography demonstrating flow to the left foot through the interposition long saphenous vein graft.
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PTA was repaired using an interposition long saphenous vein graft (Figure 4). Postoperatively, the PTA pulse was present, the foot had brisk capillary refill, and motor and sensory function normalised.