Non-traumatic Dorsalis Pedis Artery Aneurysm

A true dorsalis pedis artery aneurysm is a very rare find. This is a case presentation of a patient with an asymptomatic non-traumatic dorsalis pedis artery aneurysm. A 49-year-old man was referred to the vascular lab for evaluation of an asymptomatic non-traumatic pulsatile lump on the dorsal aspect of his left foot. The patient reported that the lump had been present for at least 4 years. Color flow duplex ultrasound was used to evaluate the lump. Color flow duplex ultrasound examination of the lump demonstrated a dilatation of the dorsalis pedis artery, measuring approximately 1.05 cm by 1.35 cm. Mural thrombus is noted in gray scale image. Normal Doppler flow was noted in the dorsalis pedis artery, proximal, and distal to the aneurysm. The patient was referred to a vascular surgeon. Subsequently, he underwent a lower extremity arteriogram confirming the diagnosis of a dorsalis pedis artery aneurysm, with good distal blood flow to the toes. The patient underwent resection of the dorsalis pedis artery aneurysm. Reverse great saphenous vein was used as an interposition graft. Follow-up graft scans demonstrated good flow in the graft and in the native artery, distal to the graft. True dorsalis pedis artery aneurysms are very rare finding. When left untreated, the patient is at risk for embolization to the digits. Color flow Doppler is a very useful tool in diagnosing and assessing these aneurysms.