Endovascular Stent Graft Repair of Traumatic Popliteal Artery Injuries

Abstract

Introduction: Popliteal artery injury is a potentially-limb threatening complication of traumatic knee dislocation. The purpose of this study was to evaluate the feasibility and effectiveness of endovascular repair of traumatic popliteal a3.102rterial injuries. Methods: A retrospective analysis of 11 patients with clinical suspicion of popliteal arterial injuries that were confirmed by arteriography was performed from September 2015 to June 2017. Clinical data included demographics, mechanism of injury, type of injury, location of injury, concomitant injuries, time of endovascular procedures, time interval from trauma to blood flow restoration, and follow-up. All patients were male (mean age of 32.7 ± 8.5 years) and suffered traumatic knee dislocation along with significant ligament and neurovascular injuries. The type of lesion involved dissection (n = 3), partial transection (n = 5), complete transection (n = 2), arteriovenous fistula (n = 1). All patients underwent endovascular repair with Viabahnâ stent graft for popliteal arterial injuries. Results: Technical success rate was 100%. No perioperative death and procedure-related complication occurred. The length of the stent graft ranged between 5 and 10 cm; the diameter of the stents was 6 mm. The average follow-up was 22.4 ± 5.6 months (range 16–25 months). One patient who underwent knee arthroplasty with tourniquet treated with catheter directed thrombolysis due to stent thrombosis at 19 months after the procedure. All limbs were salvaged. Stent graft migration, deformation, or fracture was not found during the follow-up. Conclusion: Traumatic knee dislocations are rare injuries that may be associated with potentially devastating vascular complications. A prompt diagnosis and timely arterial repair is of paramount importance if limb salvage is to be achieved. In complicated traumatic popliteal artery injuries, an endovascular stent graft implantation as a backup or bail-out technique might be a valid option in some selected cases. Further studies are required to evaluate the long-term efficacy of endovascular stent graft repair.