Alcala Elizabeth, García Romero José Manuel, Guerrero Morales Pedro Hugo, De Noriega Guzmán Daniela, Morales Rubio Alejandro
Surgery, Hospital General de Querétaro, Querétaro, MEX.
Surgery, Hospital Zambrano Hellion TecSalud, San Pedro Garza García, MEX.
Cureus. 2025 Jun 9;17(6):e85660. doi: 10.7759/cureus.85660. eCollection 2025 Jun.
Popliteal artery injuries are uncommon but carry a high risk of limb-threatening complications. Among these, pseudoaneurysms caused by penetrating trauma, such as gunshot wounds, are particularly rare and clinically significant due to their potential for delayed presentation and high morbidity. We report the case of a 46-year-old male who sustained a gunshot wound to the left thigh. CT angiography revealed a pseudoaneurysm with >50% transection of the popliteal artery. Urgent surgical repair with thrombectomy and polytetrafluoroethylene graft placement led to full neurovascular recovery. This case underscores the limitations of relying solely on clinical examination to rule out vascular injury, as distal pulses may remain intact despite significant arterial compromise. Clinicians should maintain a high index of suspicion and promptly employ imaging, especially CT angiography, in any equivocal or evolving limb trauma. The delayed onset of ischemic and neurological signs highlights the importance of maintaining a high index of suspicion and utilizing CT angiography in equivocal cases. Prompt recognition and surgical intervention, supported by advances in imaging techniques and vascular graft materials, are key to preventing irreversible damage and optimizing limb salvage outcomes.
腘动脉损伤并不常见，但具有肢体威胁性并发症的高风险。其中，由穿透性创伤（如枪伤）引起的假性动脉瘤尤为罕见，且由于其可能延迟出现和高发病率而具有临床意义。我们报告一例46岁男性，其左大腿遭受枪伤。CT血管造影显示腘动脉假性动脉瘤，动脉横断超过50%。紧急手术修复并进行血栓切除术和置入聚四氟乙烯移植物，实现了神经血管的完全恢复。该病例强调了仅依靠临床检查排除血管损伤的局限性，因为尽管动脉有明显损伤，远端脉搏仍可能保持正常。临床医生应保持高度警惕，在任何模棱两可或病情进展的肢体创伤中及时采用影像学检查，尤其是CT血管造影。缺血和神经症状的延迟出现凸显了在模棱两可的病例中保持高度警惕并使用CT血管造影的重要性。在成像技术和血管移植材料进展的支持下，及时识别和手术干预是预防不可逆损伤和优化肢体挽救结果的关键。
