Endovascular Repair after End-to-End Anastomosis for Better Outcome: A Case Report

Authors

  • Adrian Tangkilisan Universitas Sam Ratulangi
  • Wega Sukanto Universitas Sam Ratulangi
  • Christa Tamburian Universitas Sam Ratulangi
  • Rigel Paat Universitas Sam Ratulangi
  • Samuel M. Michael Universitas Sam Ratulangi

DOI:

https://doi.org/10.35790/msj.v8i1.63621

Keywords:

total anterior tibial artery rupture; penetrating trauma; vascular trauma

Abstract

Abstract: Arterial rupture is a surgical emergency that requires immediate treatment. The anterior tibial artery is the main arterial supply of the legs anterior compartment. Tibial artery rupture is a tear or rupture of the tibial artery mostly caused by vascular trauma. We reported a 54-year-old male referred to Prof. Dr. R. D. Kandou hospital with the main complaint of injury and pain in the left lower limb due to being hit by a grass cutter. On physical examination of the lateral side of left cruris region, an open wound with flat edges and muscle base appeared. The hard sign in this case was active hemorrhage and the soft sign was history of hemorrhage at the scene of the injury. During the operation, total anterior tibial artery rupture was identified with a gap less than 2 centimeters. Therefore, end-to-end anastomosis was initially performed for the 2 cm arterial gap, however, Doppler ultrasound revealed inadequate distal blood flow. Endovascular repair with drug-eluting balloon angioplasty restored good distal blood flow. Comprehensive evaluation guides optimal intervention. In conclusion, trauma to the vascular system can be devastating. In this case, there was a total anterior tibial artery rupture due to penetrating trauma. While surgery remains vital, endovascular techniques offer effective alternatives, particularly in cases of distal ischemia and minimal reconstruction needs.

Keywords: total anterior tibial artery rupture; penetrating trauma; vascular trauma

Author Biographies

Adrian Tangkilisan, Universitas Sam Ratulangi

Division of Cardiothoracic Surgery, Department of Surgery, Faculty of Medicine, Universitas Sam Ratulangi - Prof. Dr. R. D. Kandou Hospital, Manado, Indonesia

Wega Sukanto, Universitas Sam Ratulangi

Division of Cardiothoracic Surgery, Department of Surgery, Faculty of Medicine, Universitas Sam Ratulangi - Prof. Dr. R. D. Kandou Hospital, Manado, Indonesia

Christa Tamburian, Universitas Sam Ratulangi

Division of Cardiothoracic Surgery, Department of Surgery, Faculty of Medicine, Universitas Sam Ratulangi - Prof. Dr. R. D. Kandou Hospital, Manado, Indonesia

Rigel Paat, Universitas Sam Ratulangi

Division of Cardiothoracic Surgery, Department of Surgery, Faculty of Medicine, Universitas Sam Ratulangi - Prof. Dr. R. D. Kandou Hospital, Manado, Indonesia

Samuel M. Michael, Universitas Sam Ratulangi

Department of Surgery, Faculty of Medicine, Universitas Sam Ratulangi, Faculty of Medicine, Universitas Sam Ratulangi, Manado, Indonesia

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Published

2025-09-04

How to Cite

Tangkilisan, A., Sukanto, W., Tamburian, C., Paat, R., & Michael, S. M. (2025). Endovascular Repair after End-to-End Anastomosis for Better Outcome: A Case Report. Medical Scope Journal, 8(1), 150–153. https://doi.org/10.35790/msj.v8i1.63621