Endovascular therapy for iatrogenic occlusion of the popliteal artery after complex total knee arthroplasty: A case report

Imam T.P. Ritonga MD , Giuseppe Asciutto MD, PhD , Kevin Mani MD, PhD, FEBVS , Yousef Shehada MD , Marco Virgilio Usai MD
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Abstract

Iatrogenic arterial injury is an infrequent but limb-threatening complication of total knee arthroplasty (TKA). Open surgical reconstruction may not always be feasible or optimal, particularly in patients who have recently just undergone complex TKA procedures. In this report, we describe the treatment of a patient who developed popliteal artery occlusion following a complex TKA procedure performed the previous day. Although endovascular advancement allows comprehensive endovascular treatment of acute limb ischemia, their application in the context of iatrogenic arterial injury after TKA is limited, with only a few cases documented. This case is notable due to the presence of both penetrating trauma to the popliteal artery and subsequent thrombosis of the artery. These complications were successfully managed entirely through endovascular therapy, employing AngioJet rheolytic thrombolysis and the implantation of a covered stent. This case adds to the growing body of evidence supporting the use of endovascular techniques for managing this rare and complex complication of TKA.
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血管内治疗复杂全膝关节置换术后腘动脉医源性闭塞1例报告。
医源性动脉损伤是全膝关节置换术中一种少见但危及肢体的并发症。开放手术重建可能并不总是可行或最佳的,特别是那些最近刚刚经历了复杂的TKA手术的患者。在这篇报道中,我们描述了一位患者在前一天进行复杂的TKA手术后发生腘动脉闭塞的治疗。尽管血管内推进技术可以对急性肢体缺血进行全面的血管内治疗,但其在TKA后医源性动脉损伤中的应用是有限的,只有少数病例被记录在案。由于腘动脉存在穿透性创伤和随后的动脉血栓形成,该病例值得注意。这些并发症完全通过血管内治疗成功管理,采用AngioJet流变溶栓和覆盖支架植入。本病例增加了越来越多的证据,支持使用血管内技术来治疗这种罕见而复杂的TKA并发症。
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来源期刊
CiteScore
1.00
自引率
14.30%
发文量
219
审稿时长
29 weeks
期刊介绍: Journal of Vascular Surgery Cases and Innovative Techniques is a surgical journal dedicated to publishing peer review high quality case reports, vascular images and innovative techniques related to all aspects of arterial, venous, and lymphatic diseases and disorders, including vascular trauma, malformations, wound care and the placement and maintenance of arterio-venous dialysis accesses with an emphasis on the practicing clinician. The Journal seeks to provide novel and timely information to vascular surgeons, interventionalists, phlebologists, wound care specialists, and allied health professionals involved with the management of patients with the entire spectrum of vascular disorders.
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