Posttraumatic pseudoaneurysm of popliteal artery following total knee arthroplasty

Abstract

We report a case of posttraumatic false aneurysm of popliteal artery after a total knee arthroplasty in an 82-year-old woman. This case is characterized by the distinct history of trauma to the popliteal fossa in the immediate postoperative period and the location of false aneurysm. In addition, the clinical symptoms were similar to those of deep vein thrombosis. The ultrasonographic examination and computed tomography (CT) angiography confirmed the diagnosis on 6th day after the surgery. Ultrasonographic examination 1 day later revealed no increase in the size of false aneurysm. She was treated with open surgical repair. Presenting the difficulty in the diagnosis, unusual location, etiology, and its management is the intention of this case report.

Missed diagnosis of false aneurysm of the superficial femoral artery after closed complex fracture of the distal femur

“…All three cases share almost the same mechanism and type of injury, means of treatment, clinical presentation and diagnostic studies. Progressive anemia was reported by the other authors, but was also clearly present in reports of false aneurysm in other locations [9,11,12]. In our opinion, it constitutes an important sign of ongoing blood leakage.…”

“…False aneurysm, on the other hand, is a serious complication not frequently seen in traumatology and orthopedic practice and which, left untreated, can cause rupture and acute limb ischemia due to thrombosis or distal embolization. In a search of the recent literature, a few publications concerning the deep femoral artery [6][7][8][9], brachial artery [10] and PA [11] could be found. Clinically, if the vessel is severely injured, an acute presentation will be observed, with swelling, compartment syndrome, wound leakage, signs of internal bleeding, acute anemia and weak or absent distal pulse.…”

Local infiltration analgesia in primary total knee arthroplasty

“…Nonetheless, popliteal artery pseudoaneurysm is an uncommon complication of TKA that has been previously reported. 38,39 Pseudoaneurysm implies that trauma to the artery may have occurred during TKA, which may comprise direct incision, injury during the injection of LIA, or blunt instrument trauma (eg, from an oscillating saw). With the increasing use of LIA, it is important to consider the risk of vascular complications during injection into the posterior capsule.…”

Stent graft repair of anastomotic pseudoaneurysm of femoral–popliteal bypass graft following patch angioplasty

“…The cumulative risk of a clinically significant PA after surgery is 2–6% [3]. There have been reports of popliteal PA following total knee arthroplasty, acupuncture and percutaneous transluminal angioplasty [4–6]. To the best of our knowledge, we present the first case of popliteal PA of the distal anastomosis of a femoral–popliteal bypass following patch angioplasty 10 years prior.…”