Kehagias Elias, Ioannou Christos V, Kontopodis Nikolaos, Balalis Constatinos, Tsetis Dimitrios
Interventional Radiology Unit, Radiology Department, University of Crete Medical School, Heraklion, Crete, Greece.
Vascular Surgery Unit, Department of Cardiothoracic and Vascular Surgery, University of Crete Medical School, Heraklion, Crete, Greece.
Ann Vasc Surg. 2015 Oct;29(7):1453.e9-1453.e14. doi: 10.1016/j.avsg.2015.04.081. Epub 2015 Jun 30.
Injury to the popliteal vessels during total knee arthroplasty is a rare but serious complication that can cause permanent loss of function. Its incidence has been reported to be on the rise with an incidence ranging from 0.03% to 0.51%. Although rare, these complications deserve attention as they may have dire consequences, with mortality reaching 7%, amputation in up to 42%, and other morbidities such as ischemic nerve injury (foot drop). We present a case of a 78-year-old female with a pulseless limb after intraoperative injury of the popliteal artery during total knee replacement surgery who was immediately investigated with digital subtraction angiography and found to have a popliteal artery laceration with significant bleeding and a distal occlusion of the artery that was repaired endovascularly. A covered stent graft was used to simultaneously exclude the arterial laceration and to recanalize the localized popliteal occlusion. To our knowledge, this is the first report of an iatrogenic popliteal artery laceration and occlusion treated endovascularly in the intraoperative time.
全膝关节置换术中腘血管损伤是一种罕见但严重的并发症，可导致永久性功能丧失。据报道，其发生率呈上升趋势，发生率在0.03%至0.51%之间。尽管罕见，但这些并发症值得关注，因为它们可能会产生严重后果，死亡率达7%，截肢率高达42%，还会出现其他并发症，如缺血性神经损伤（足下垂）。我们报告一例78岁女性，在全膝关节置换手术中腘动脉术中损伤后出现无脉肢体，立即接受数字减影血管造影检查，发现腘动脉撕裂并有大量出血，动脉远端闭塞，通过血管腔内修复。使用覆膜支架移植物同时封闭动脉撕裂处并使局部腘动脉闭塞再通。据我们所知，这是术中血管腔内治疗医源性腘动脉撕裂和闭塞的首例报告。
