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Jun10

Mycotic aneurysms of the lower limb vessels are rare.Still rarer is to find mycotic aneurysms of the small sized tibial vessels of the legs.Few cases of mycotic aneurysm involving  posterior tibial artery has been reported .We report a case of mycotic aneurysm of the anterior tibial artery done in our institute until recently.To the best of  our knowledge this is the first of its kind case reported in vascular surgery literature wherein the origin of anterior tibial artery was involved .

 

       A 42 years old man came to the hospital complaining of severe pain in his left leg of  short duration.The pain was so severe that he was not able to walk even few steps.He had no significant medical history and was not on any kind of medications.On examination it was found that his left leg was swollen and left foot was cold.Left dorsalis pedis and posterior tibial artery pusations were not felt.He was febrile and subsequent examination revealed he had mitral valve disease with fresh vegetations on its leaflets.So a diagnosis of infective endocarditis was clinically made which was subsequently confirmed my 2D Echo and CT angio of the patient.

  Patient was explained in detail as to what was going on and was taken up for emergency surgery of his left leg as blood flow was severely compromised which could have endangered the viability of his leg otherwise.Under strong antibiotic cover the surgery was performed.Left ATA mycotic aneurysm was excised in totality. Blood circulation was restored in the other vessel of the leg i.e posterior tibial artery .Reconstruction was not done for the anterior tibial artery for fear of infection and subsequent vascular blowout because of underlying infective pathology.

                      Patient was discharged on the 5th post.operative day and is advised to be in regular follow up of my own self and the cardiologist.



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