Popliteal Artery Pseudoaneurysm After Arthroscopic Cystectomy of a Popliteal Cyst

A case of popliteal artery aneurysm after arthroscopic cystectomy of a popliteal cyst is an uncommon complication, and no case has been reported. We present a case of pseudoaneurysm of the popliteal artery after arthroscopic cystectomy of a popliteal cyst 2 months after surgery. Open excision of the pseudoaneurysm and popliteal artery pin-point repair were done. At 30 months' follow-up, both the tibialis posterior and dorsalis pedis pulsations were felt equally on both sides with normal sensations over the limb. Retrospectively reviewing the case, we found that the relation of the popliteal artery and popliteal cyst on preoperative magnetic resonance images can predict the complication of pseudoaneurysm of the popliteal artery. It is better not to shave the lateral aspect of the cyst while performing arthroscopic cystectomy when magnetic resonance images show that the popliteal artery is close to the cyst.     

False aneurysm of the popliteal artery treated successfully by surgery: Report of two cases

Blunt trauma to the popliteal artery may result in pseudoaneurysm formation. We herein report two patients who had a pseudoaneurysm of the popliteal arteries without any orthopedic injuries. One patient, who had been struck by an iron plate in the midthigh portion, demonstrated a pulsatile mass in this area 2 months later. The other patient had a pseudoaneurysm that was diagnosed by a histological examination; however, he could not remember having suffered any noticeable trauma.     

膝关节置换术腘动脉损伤的治疗体会

目的探讨膝关节置换术腘动脉损伤的原因及治疗方法。 方法回顾性分析2010年10月至2018年5月就诊于烟台市烟台山医院的6例膝关节置换术出现腘动脉损伤患者的临床资料,其中5例为腘动脉假性动脉瘤,1例为腘动脉血栓形成,腘动脉假性动脉瘤予以局部压迫、注射凝血酶、腘动脉修补治疗,腘动脉血栓形成予以置管溶栓治疗。 结果1例腘动脉血栓性形成经置管溶栓后动脉血流恢复,5例腘动脉假性动脉瘤经治疗后均消失,其中1例经局部加压,1例经局部注射凝血酶,3例经腘动脉修补治疗。 结论膝关节置换术腘动脉损伤的原因与患者自身基础疾病、血管条件及术中操作等有关,根据患者腘动脉损伤情况选择合适治疗方式可以得到有效的治疗。     

Chronic pseudoaneurysm of the popliteal artery after blunt trauma

Blunt trauma to the popliteal artery usually results in acute arterial damage that requires urgent repair. Most blunt trauma to the popliteal artery is associated with skeletal injuries. We report a patient who had a chronic pseudoaneurysm of the popliteal artery 10 years after minor blunt trauma to the popliteal fossa. The cause of the pseudoaneurysm and suggestions for the early recognition of these arterial injuries are discussed.     

Popliteal pseudoaneurysm caused by Nora's lesion of the femur in a young child: A rare presentation and first report

Bizarre parosteal osteochondromatous proliferation (BPOP), or Nora's lesion, was first described by Nora et al. in 1983 as a rare, tumor-like lesion involving the bones of the hands and feet. Popliteal artery pseudoaneursyms in the pediatric population are also unusual. Here, we present a case of a young male with a popliteal artery pseudoaneurysm and distal femur lesion originally thought to be an osteochondroma. A 10-year old, Caucasian male was referred to our facility following an MRI concerning for a popliteal artery pseudoaneurysm. On physical exam, there was a palpable 5 × 5-cm pulsatile mass in the upper popliteal fossa with a normal pulse exam bilaterally. A computed tomographic angiogram demonstrated a 4.5-cm by 1.8-cm by 3.6-cm pseudoaneurysm adherent to a 3.5-cm thick, exostotic lesion of the posterior right femur. He was taken to the operating room for repair of the popliteal pseudoaneurysm and resection of his bone lesion. The final pathology was consistent with a popliteal pseudoaneurysm, osteochondroma, and bizarre parosteal osteochondromatous proliferation (BPOP), otherwise known as Nora's lesion. The location of the lesion and the age of our patient were both atypical for BPOP and to our knowledge, this represents the first report of a resulting popliteal artery pseudoaneurysm.     

Popliteal Artery Pseudoaneurysm Caused by Osteochondroma

A 49-year-old man with asymptomatic osteochondroma was found to have a pseudoaneurysm of the left popliteal artery. An angiography showed a popliteal artery pseudoaneurysm adjacent to a femoral osteochondroma. The osteochondroma was excised and the popliteal artery containing the tear was also excised by end-to-end anastomosis. Vascular complication of osteochondroma is extremely rare. Paul reported the first case of a popliteal artery pseudoaneurysm due to an osteochondroma in 1953. A computerized literature search revealed 40 additional cases reported in English, providing sufficient detail to allow comparison. The average age of the patients was 22.6 years (range: 9-51 years) and most cases identified involved males (30 of 41, 73%). Most pseudoaneurysms were located in the popliteal artery. This report discusses the authors experience with this disorder and a review of the literature in English.     

Pseudoaneurysm of the popliteal artery after hardware removal in a patient with Marfan syndrome

The formation of pseudoaneuryms after orthopaedic procedures in the setting of connective tissue disorders such as Marfan syndrome (MFS) is not well documented in the literature. We report the case of a seventy-one year old male with MFS who underwent uncomplicated distal interlocking screw removal from a femoral cephalomedullary nail for symptomatic hardware. Five weeks later, he presented with a popliteal artery pseudoaneurysm. The patient underwent successful open ligation and excision of the pseudoaneurysm. This is the first reported case of a popliteal artery pseudoaneurysm following orthopaedic hardware removal in a patient with MFS. MFS may predispose patients to peripheral vascular complications even in the most routine cases. A thorough understanding of the patient and complications associated with MFS is required prior to proceeding with elective orthopaedic surgery.     

Osteochondroma as a causal agent in popliteal artery pseudoaneurysms: case report and literature review

Osteochondromas are an infrequent, but significant, source of vascular injuries. Popliteal artery pseudoaneurysms are the most common sequelae, with a complex interplay of anatomic and developmental factors accounting for their prevalence. The authors present a case report, detailed discussion, and literature review of pseudoaneurysm formation in the popliteal artery.     

Pseudoaneurysm complicating knee arthroscopy. A case report

Pseudoaneurysm formation is a rare complication after knee arthroscopy. Most pseudoaneurysms complicating knee arthroscopy develop on the popliteal and geniculate arteries. We report a case of a pseudoaneurysm developed on an arterial branch to the medial gastrocnemius muscle, as a complication of an arthroscopic meniscectomy in a 66-year-old patient. The patient was treated successfully by resection of the pseudoaneurysm and ligation of the injured artery.     

Association of deep venous thrombosis and popliteal pseudoaneurysm after arthroscopic meniscectomy

Popliteal pseudoaneurysm is an infrequent outcome of closed or penetrating injuries to the popliteal artery. An unusual case of iatrogenic right popliteal pseudoaneurysm in a female patient referred to our attention 20 days after arthroscopic meniscectomy is described.     

Popliteal Pseudoaneurysm After Total Knee Arthroplasty Secondary to Intraoperative Arterial Injury With a Surgical Pin : Review of the Literature

Pseudoaneurysms of the popliteal artery after total knee arthroplasty are rare. Although many possible explanations are proposed in the literature, no intimate mechanism of injury to the artery is previously described. We report on a case of popliteal pseudoaneurysm after a total knee arthroplasty that presented clinically on the second postoperative day. Open vascular surgery with resection of the pseudoaneurysm and end-to-end bypass of contralateral saphena vein graft was successfully performed. At the time of the surgery, a hole was clearly identified on the anterior wall of the popliteal artery due to a perforation with a pin used during the knee arthroplasty. The patient had no further complications.     

Popliteal pseudoaneurysm after total knee arthroplasty secondary to intraoperative arterial injury with a surgical pin: review of the literature

Pseudoaneurysms of the popliteal artery after total knee arthroplasty are rare. Although many possible explanations are proposed in the literature, no intimate mechanism of injury to the artery is previously described. We report on a case of popliteal pseudoaneurysm after a total knee arthroplasty that presented clinically on the second postoperative day. Open vascular surgery with resection of the pseudoaneurysm and end-to-end bypass of contralateral saphena vein graft was successfully performed. At the time of the surgery, a hole was clearly identified on the anterior wall of the popliteal artery due to a perforation with a pin used during the knee arthroplasty. The patient had no further complications.     

Late presentation of a mycotic popliteal artery pseudoaneurysm in the setting of a revised total knee arthroplasty complicated by both prior infection and periprosthetic fracture: a case report

Reports of adverse arterial events associated with total knee arthroplasty (TKA), such as ischemia, thrombosis, arterial injury, or pseudoaneurysm, are relatively rare in the orthopedic and vascular literature and are most commonly associated with direct trauma to the vessel. Additionally, arterial complications typically present within a short postoperative time frame. A delayed presentation of a mycotic arterial pseudoaneurysm in the setting of a revision arthroplasty complicated by infection and fracture has not, to the best knowledge of the authors, been described in the literature. We report the delayed presentation of a mycotic pseudoaneurysm in the setting of a revision TKA previously complicated by both infection and periprosthetic fracture. One year after fracture repair, the patient presented with acute thigh swelling and was diagnosed with a mycotic pseudoaneurysm of the right proximal popliteal artery. He was treated with surgical excision, reverse saphenous vein interpositional grafting, and a long-term course of broad-spectrum antibiotics. In the setting of a revision TKA and previous complications, the risk of future complications is increased and may not always involve direct vascular trauma. In patients with previously infected joints and new-onset vascular events, mycotic pseudoaneurysm must be included in the differential diagnosis.     

Popliteal pseudoaneurysm following total knee arthroplasty

Arterial injuries complicating total knee arthroplasty are rare but may result in significant morbidity. There are three reports of popliteal artery pseudoaneurysm resulting from arterial trauma during total knee replacement. We report a case of a popliteal pseudoaneurysm with rupture into the surrounding muscle, its evaluation, and successful repair 5 months after arthroplasty.     

Stent graft exclusion of a ruptured mycotic popliteal pseudoaneurysm complicating sternoclavicular joint infection

A mycotic pseudoaneurysm of the popliteal artery is usually a consequence of septic embolization and often a result of bacterial endocarditis. Conventional treatment is surgical and avoids the placement of foreign material in infected sites. Here we report our treatment of a 59-year-old man who presented with a rupture of a mycotic pseudoaneurysm of the popliteal artery due to septic embolism from sternoclavicular infectious arthritis. Radiological investigations are included. This is the first documented case of septic arthritis complicated by a rupture of a mycotic popliteal false aneurysm and treated using an endovascular procedure. Combining endovascular stent grafts with evacuation of the joint abscess and antibiotic therapy can offer a safe alternative for frail and unstable patients.     

A case of external carotid artery pseudoaneurysm from hyoid bone fracture

Carotid artery pseudoaneurysms are detected most commonly after acute traumatic injuries to the head and neck. Pseudoaneurysms of the carotid artery are rare after blunt trauma. The most common site of injury occurs in the internal carotid artery with greater than 70 per cent of those injuries resulting from motor vehicle collisions. We report a case of external carotid artery pseudoaneurysm secondary to chronic arterial trauma. The patient presented with a one-week history of left ear pain and a pulsatile left neck mass. Radiologic studies revealed a 2.8-cm neck mass compatible with a pseudoaneurysm of the external carotid artery. Primary repair of the aneurysm was performed. Exploration of the pseudoaneurysm cavity at the time of surgery revealed a fracture of the hyoid bone. We believe this to be the contributing factor to the formation of a pseudoaneurysm in this patient. This is the first reported case of external carotid pseudoaneurysm caused by chronic arterial injury secondary to hyoid bone fracture.     

Common peroneal nerve palsy from an untreated popliteal pseudoaneurysm after penetrating injury

A 17-year-old boy presented with drop foot and loss of extension in his left knee after penetrating injury to the popliteal region. Color duplex ultrasonography and angiography revealed a popliteal artery pseudoaneurysm in the popliteal fossa. Electrodiagnostic tests demonstrated nearly total common peroneal nerve injury. The delay in diagnosis from the time of injury was 1 month. The pseudoaneurysm was repaired with primary suture through a medial incision. Epineurolysis of the common peroneal nerve was performed a week later through a posterolateral incision. Pain and knee contracture resolved after surgery. Drop foot recovered completely after 1 year.     

Pseudoaneurysm of the superficial femoral artery associated with osteochondroma--a case report

Osteochondromas, the most common benign bone tumor, often go undetected and seldom cause significant clinical sequelae. Rarely they present as an arterial pseudoaneurysm, usually of the popliteal or superficial femoral artery. The authors present the case of a 14-year-old male with a distal superficial femoral artery pseudoaneurysm accompanied by distal embolization from a femoral exostosis.     

Traumatic popliteal artery pseudoaneurysms: case report and review of the literature

Traumatic pseudoaneurysms of the popliteal artery are an uncommon late complication of arterial injury. Although reviewed extensively in wartime, they occur less frequently in civilian trauma and have accordingly been less frequently studied. A case report of a traumatic popliteal artery pseudoaneurysm and review of the literature are presented.     

Pseudoaneurysm of the popliteal artery after anterior cruciate ligament reconstruction with bicortical tibial screw fixation

We present a case report of a pseudoaneurysm of the popliteal artery after anterior cruciate ligament reconstruction using a bicortical tibial screw fixation 12 days after surgery. Surgical exploration and repair of an intimal lesion of the popliteal artery was performed. At 4-months’ follow-up, there was still sensory loss in areas of the saphenous, medial plantar, calcaneal, and superficial peroneal nerves.