Transpedal Retrograde Recanalisation of a Dorsalis Pedis Artery Occlusion Associated With Arteriovenous Fistula After Combined Arthroscopic and Mini Open Talocalcaneotibial Arthrodesis

Czihal, Michael; Baumbach, Sebastian; Polzer, Hans; Deniz, Sinan (2026): Transpedal Retrograde Recanalisation of a Dorsalis Pedis Artery Occlusion Associated With Arteriovenous Fistula After Combined Arthroscopic and Mini Open Talocalcaneotibial Arthrodesis. EJVES Vascular Forum, 65. pp. 170-174. ISSN 2666688X

Abstract

Objective

Arterial injury following hindfoot fusion is an exceptionally rare but serious complication that may result in limb threatening ischaemia.

Methods

This report presents the case of a 71 year old man who experienced acute foot ischaemia after undergoing combined arthroscopic and mini-open tibiotalocalcaneal arthrodesis. Angiography revealed anterior tibial artery occlusion with an arteriovenous fistula. After failed antegrade attempts, transpedal retrograde recanalisation via the dorsalis pedis artery successfully restored perfusion and excluded the fistula.

Results

This case highlights the potential for arterial injury as a rare complication of complex hindfoot procedures. It underscores the importance of multidisciplinary collaboration between orthopaedic and endovascular specialists and demonstrates that minimally invasive recanalisation techniques can effectively salvage the limb and prevent major amputation.

• Doc-Type: Article (LMU Hospital)
• Organisational unit (Faculties): 07 Medicine > Medical Center of the University of Munich > MUM - Musculoskeletal University Center Munich; 07 Medicine > Medical Center of the University of Munich > Medical Clinic and Outpatient Clinic IV (Endocrinology, nephrology, other sections)
• DFG subject classification of scientific disciplines: Life sciences
• DFG: Funded by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) - 491502892