|Year : 2016 | Volume
| Issue : 4 | Page : 145-146
Saravanan Balachandran1, M Rajkumar1, SR Subrammaniyam1, M Suganya2
1 Department of Vascular Surgery, Mount Multispeciality Hospitals, Chennai, Tamil Nadu, India
2 Department of General Medicine, Mount Multispeciality Hospitals, Chennai, Tamil Nadu, India
|Date of Web Publication||30-Sep-2016|
Department of Vascular Surgery, Mount Multispeciality Hospitals, Chennai, Tamil Nadu
Source of Support: None, Conflict of Interest: None
Aneurysm of the foot is rare. These aneurysms are diagnosed based on clinical examination and angiogram. The treatment protocol was based on the angiogram, and the culture examination of the specimen will definitely have a role to play in the overall management of the patient.
Keywords: Aneurysm, angiogram, bypass, culture examination, dorsalis pedis artery
|How to cite this article:|
Balachandran S, Rajkumar M, Subrammaniyam S R, Suganya M. Foot Aneurysms. Indian J Vasc Endovasc Surg 2016;3:145-6
| Introduction|| |
Aneurysm of the dorsalis pedis artery is rare, and very few cases have been reported in the literature. We report the management of a mycotic peripheral aneurysm.
| Case Report|| |
A 63-year-old female was referred for foot pain with suspected aneurysmal swelling in the foot. On clinically evaluating, the patient is a known diabetic and hypertensive on medications. She noticed the swelling for the past 6 months with a minimal increase in size for the past 6 months. The patient denies history of trauma  or any other intervention to the foot.
On examination, the pulsatile swelling [Figure 1] was approximately 2.5 cm × 1.8 cm in size over the dorsal aspect of foot which is tender to touch. Clinically, the swelling was diagnosed as dorsalis pedis artery aneurysm; hence, after routine blood investigation including surgical profile, she was subjected to angiogram [Figure 2] to confirm the diagnosis, to determine the blood flow to the extremities, and to rule out other peripheral aneurysms. 
Based on the angiogram, the patient was subjected to excision of aneurysm [Figure 3] with primary repair , [Figure 4] of the artery. Postoperative period was uneventful with palpable distal pulses; further, digital flow was confirmed with hand Doppler examination. The specimen was subjected to pathological studies and for culture examination.
The culture  was positive for salmonella hence was treated with antibiotics accordingly.
| Discussion|| |
Aneurysm of the dorsalis pedis artery is rare, and very few cases have been reported in the literature. These aneurysms have vague presentation with pain, neurological compressive symptoms, or very rarely ischemic pain  over the extremities. The patients usually present with dorsalis pedis artery aneurysm after trauma  or after any surgical intervention in the foot or after an IV access.
The treatment protocol is based after confirming the diagnosis by clinical examination, Duplex studies, and angiogram. Various treatment options are available for the reconstruction of the artery in the form of primary repair or bypass or by ligation of the artery.
This patient has undergone primary repair considering the atherosclerotic nature, and there is a possibility of future distal ischemia to the toes. In addition, painful aneurysms necessitated the need to intervene in a case of dorsalis pedis artery aneurysm. The specimen was subjected to culture examination to treat the underlying bacteremia which could be one of the etiological factors.
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Conflicts of interest
There are no conflicts of interest.
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[Figure 1], [Figure 2], [Figure 3], [Figure 4]