To explore the ultrasonographic characteristics of posterior tibial artery pseudoaneurysm with nerve injury and the therapeutic value of ultrasound-guided thrombin injection.

A patient with posterior tibial artery pseudoaneurysm accompanied by tibial nerve injury due to trauma admitted to the Department of Vascular Surgery, the Affiliated Hospital of Jining Medical University on April 2, 2020 was confirmed by ultrasonography and CT angiography, and treated with ultrasound-guided thrombin injection. The treatment process, curative effect and complications were analyzed, and the relevant literatures were reviewed.

The patient presented pain in the right calf, accompanied by swelling, and numbness on the sole of the foot. Ultrasound manifested a mixed echo mass next to the right posterior tibial artery. The red and blue turbulent blood flow signals could be detected in the liquid dark area of the mass, and the high-speed jet signals originating from the posterior tibial artery could be detected, two-phase bidirectional blood flow spectrum could be explored at the communicating hole. Ultrasound diagnosed as right posterior tibial artery pseudoaneurysm with mural thrombus in the pseudoaneurysm. Under the guidance of ultrasound, thrombin injection was used to treat the posterior tibial artery pseudoaneurysm. After treatment, except for the aggravated tibial nerve injury, no other complications occurred. There was no recurrent blood flow signal in the pseudoaneurysm one day after treatment. Re-examinations 1 and 3 months after treatment showed that the pseudoaneurysm gradually became smaller, and the patient′s tibial nerve injury symptoms gradually alleviated, and no other complications appeared.

Ultrasonography has certain clinical application value in diagnosing posterior tibial artery pseudoaneurysm and guiding thrombin injection therapy.