Nazari Iraj, Zargar Mohammad Amin, Nazari Ashkan, Alavi Seyed Mohammad Amin
Department of General Surgery, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Department of General Surgery, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Int J Surg Case Rep. 2024 Sep;122:109988. doi: 10.1016/j.ijscr.2024.109988. Epub 2024 Jul 5.
Popliteal artery pseudoaneurysm is a state of vascular wall rupture in the popliteal artery. It is generally a rare situation and the most common etiologic factor is iatrogenic causes.
This case report presents a successful diagnosis and management of a 31-year-old patient who was presented with a mass behind the knee, three months after femoropopliteal bypass for the treatment of a gunshot to the knee. An endovascular approach using coils was utilized for the patient, which led to complete remission for the patient.
The current patient had two primary therapeutic challenges: bleeding and hematoma growth, clot development causing blood flow restriction, and limb ischemia. Pseudoaneurysm also caused internal inflammation, which increased the risk of thrombosis and bypass graft damage during open surgery. Due to the risk of recurrence and graft damage, ultrasound-guided compression was not possible. Thus, endovascular therapy was preferred.
The endovascular approach using coils is an option for the management of PAP. However, the endovascular approach should be considered carefully according to the patient's status.
腘动脉假性动脉瘤是腘动脉血管壁破裂的一种状态。它通常是一种罕见情况，最常见的病因是医源性因素。
本病例报告展示了对一名31岁患者的成功诊断和治疗。该患者在因膝部枪伤接受股腘动脉搭桥术后三个月，出现腘窝处肿块。对该患者采用了使用弹簧圈的血管内治疗方法，使患者完全康复。
当前患者面临两个主要治疗挑战：出血和血肿增大、血栓形成导致血流受限以及肢体缺血。假性动脉瘤还引起内部炎症，增加了开放手术期间血栓形成和旁路移植血管受损的风险。由于存在复发和移植血管受损的风险，无法进行超声引导下压迫治疗。因此，血管内治疗是首选。
使用弹簧圈的血管内治疗方法是治疗腘动脉假性动脉瘤的一种选择。然而，应根据患者的状况仔细考虑血管内治疗方法。
