LAUSR

OBJECTIVE The effectiveness of endovascular treatment for popliteal arterial injury has not been well documented. This study was aimed to investigate the mid-term outcomes of endovascular repair of traumatic isolated popliteal arterial injury. METHODS Medical records of the patients who underwent endovascular repair for traumatic popliteal arterial injuries from January 2012 to February 2020 were reviewed retrospectively. Clinical data including patient demographics, Injury Severity Score (ISS), type of injury, classification of acute limb ischemia, concomitant extremity fracture, runoff vessel status, complications, time of endovascular procedure, time interval from injury to blood flow restoration, length of hospital stay, reintervention, and follow-up were collected and analyzed. RESULTS Endovascular repair was performed in 46 patients with traumatic popliteal arterial injuries. The mean ISS was 15.8±6.2. The overall limb salvage rate was 89.1%. There were 10 penetrating and 36 blunt injuries (78.3%). Initial angiographic findings revealed: occlusion in 34 patients (73.9%), pseudoaneurysm in 2 (4.4%), active extravasation in 9 (19.5%), and arteriovenous fistulas in 1 (2.2%). Technical success was achieved in all 46 patients, via antegrade access in 24 patients (52.2%) and concurrent retrograde access in 22 (47.8%). The mean time interval from popliteal artery injury to blood flow restoration was 10.6±4.9 hours and mean operative time was of 54.9±10.0 minutes. The mean follow-up was 36.1 ±14.5 months. Primary patency rate was 75.3% at 12 months, 61.9% at 24 months and 55.7% at 48 months. Secondary patency rate was 92.2% at 12 and 24 months, 85.2% at 48 months. Cox multivariate analysis revealed single vessel runoff was independent risk factor for primary patency loss. CONCLUSIONS Endovascular repair of isolated popliteal artery injury may be a safe and effective alternative treatment in select patients, with acceptable mid-term outcomes. Single vessel runoff was an independent risk factor for primary patency loss.