True aneurysm of the dorsalis pedis artery

Abstract

Objective: To report a rare case of true aneurysm of the dorsalis pedis artery, describing its clinical presentation, diagnosis, and surgical management. Case details: A 44-year-old male, with a 21-year history of hypertension and former smoker, presented with discomfort in the right foot during ambulation. Physical examination revealed a pulsatile nodule in the topographic area of the dorsalis pedis artery, with increased local pulse amplitude. Posterior tibial and dorsalis pedis pulses were present, with no signs of ischemia or microembolization. Computed tomography angiography showed a tortuous saccular aneurysm measuring 1.5 cm in length and 5.9 mm in maximum diameter. The patient underwent aneurysmectomy with end-to-end anastomosis using 6-0 Prolene under spinal sedation and local anesthesia. The postoperative period was uneventful, with preserved peripheral perfusion and satisfactory wound healing. Histopathological analysis confirmed a true aneurysm. Final considerations: True aneurysms of the dorsalis pedis artery are rare but should be considered in the differential diagnosis of pulsatile masses on the dorsum of the foot. Resection with end-to-end anastomosis proved to be a safe and effective technique in this case.