Renaissance School of Medicine at Stony Brook University, Stony Brook, NY.
Division of Vascular and Endovascular Surgery, Department of Surgery, Stony Brook University Hospital, Stony Brook, NY; Limb Preservation Center, Division of Vascular and Endovascular Surgery, Stony Brook University Hospital, Stony Brook, NY.
Ann Vasc Surg. 2023 Aug;94:263-271. doi: 10.1016/j.avsg.2023.01.055. Epub 2023 Mar 1.
Popliteal artery pseudoaneurysms are a rare but serious complication following total knee arthroplasty that have been traditionally managed with open surgical repair. Endovascular stenting, while relatively new, offers a promising alternative that is less invasive and may reduce the risk of perioperative complications.
A systematic literature review was conducted, and all clinical reports in the English language from inception to July 2022 were identified. References were manually reviewed to identify additional studies. Demographics, procedural techniques, postprocedural complications, and followup data were extracted and analyzed using STATA 14.1. Additionally, we present a case of a patient with a popliteal pseudoaneurysm treated with a covered endovascular stent.
A total of 14 studies (12 case reports, 2 case series; n = 17) were included for review. In all cases, a stent-graft was placed across the popliteal artery lesion. In 5 out of 11 cases, popliteal artery thrombus was present and treated with adjacent modalities (i.e., mechanical thrombectomy, balloon angioplasty, etc.). Procedure success was reported in all cases without perioperative adverse events. Stents remained patent over a median followup of 32 weeks (interquartile range: 36). In all but one case, the patients experienced immediate symptom relief and had an uneventful recovery. For our case, at the 12-month followup the patient was asymptomatic, and ultrasound demonstrated vessel patency.
Endovascular stenting is a safe and effective treatment for popliteal pseudoaneurysms. Future studies should be aimed at evaluating the long-term outcomes of such minimally invasive techniques.
腘动脉假性动脉瘤是全膝关节置换术后一种罕见但严重的并发症，传统上采用开放手术修复。血管内支架置入术虽然相对较新，但提供了一种有前途的替代方法，其创伤较小，可能降低围手术期并发症的风险。
进行了系统的文献回顾，并确定了从开始到 2022 年 7 月所有英文临床报告。通过手动审查参考文献来识别其他研究。使用 STATA 14.1 提取并分析人口统计学、程序技术、术后并发症和随访数据。此外，我们还介绍了 1 例采用覆膜血管内支架治疗腘动脉假性动脉瘤的病例。
共纳入 14 项研究（12 例病例报告，2 例病例系列；n=17）进行综述。在所有情况下，支架均横跨腘动脉病变放置。在 11 例中有 5 例存在腘动脉血栓，采用邻近的方法（即机械血栓切除术、球囊血管成形术等）进行治疗。所有病例均报告手术成功，无围手术期不良事件。支架在中位随访 32 周（四分位距：36）时保持通畅。除 1 例外，所有患者均立即缓解症状，恢复顺利。在我们的病例中，在 12 个月的随访时，患者无症状，超声显示血管通畅。
血管内支架置入术是治疗腘动脉假性动脉瘤的一种安全有效的方法。未来的研究应旨在评估此类微创技术的长期结果。
