Syed Saad Ali
Introduction
True aneurysms of the dorsalis pedis artery are exceptionally rare, with fewer than 30 cases reported in the literature, and may present as a dorsal foot mass, often mimicking benign conditions. With increasing emphasis on ambulatory surgery, there is a need to evaluate the suitability of uncommon vascular pathologies for day-case management. This case, alongside a literature review, explores peri-operative considerations relevant to elective day surgery pathways.
Methods
We present a case of a patient with a progressively enlarging, pulsatile dorsal foot mass. Diagnosis was established using duplex ultrasound and computed tomography angiography. Elective surgical repair was performed. A review of previously reported cases was undertaken to assess presentation, operative management, and outcomes.
Results
Imaging confirmed a true dorsalis pedis artery aneurysm with mural thrombus. Surgical repair was successfully performed with preservation of distal perfusion and an uncomplicated recovery. Review of the literature identified fewer than 30 reported cases, with consistently favourable surgical outcomes. However, no studies specifically addressed peri-operative pathways or suitability for day-case management.
Conclusions
This case highlights the potential for selected peripheral vascular procedures to be incorporated into elective day-case pathways. Key considerations include adequate distal perfusion, limited comorbidity, procedural complexity, and the ability to meet criteria-led discharge. Recognition of such cases may support the expansion of ambulatory vascular surgery while maintaining patient safety.
Authors
Syed Saad Ali, Matthew Popplewell
NHS, Wolverhampton, United Kingdom