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Microsurgical Clip Obliteration of Middle Cerebral Aneurysm Using Intraoperative Flow Assessment

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Published on: September 25, 2009

Ruptured mycotic infrapopliteal aneurysm.

Irina Shakhnovich¹, Gary R Seabrook, Kellie R Brown

¹Division of Vascular Surgery, Medical College of Wisconsin, Milwaukee, WI 53226, USA.

Journal of Vascular Surgery

|January 29, 2013

Summary

Mycotic aneurysms of the infrapopliteal arteries are rare, especially when ruptured. This case details the largest reported ruptured infrapopliteal aneurysm, successfully treated with surgical ligation and reconstruction.

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Area of Science:

Vascular Surgery
Infectious Disease

Background:

Mycotic aneurysms, infections of arterial walls, are uncommon, particularly in the infrapopliteal arteries.
Ruptured infrapopliteal aneurysms are rare surgical emergencies requiring prompt intervention.

Observation:

A 51-year-old male presented with a large (12-cm) ruptured aneurysm of the tibioperoneal trunk.
The aneurysm occurred 5 years after a history of bacterial endocarditis, suggesting a potential infectious etiology.

Findings:

The case describes the largest reported ruptured infrapopliteal aneurysm in the English literature.
Surgical management involved extremity exsanguination and tourniquet application for hemorrhage control during aneurysm ligation.
Successful arterial reconstruction was achieved following aneurysm ligation.

Implications:

This case highlights a rare but critical vascular emergency.
The described surgical technique provides a viable approach for managing large, ruptured infrapopliteal mycotic aneurysms.
Early recognition and aggressive surgical management are crucial for favorable outcomes in such rare presentations.