Posterior Approach for Revascularization in Blunt Popliteal Vessel Injury.

Makaloski, Vladimir; Stellmes, Arno; Wyss, Dörte; Weiss, Salome; Becker, Daniel; Wyss, Thomas; Schmidli, Jürg (2018). Posterior Approach for Revascularization in Blunt Popliteal Vessel Injury. Annals of vascular surgery, 48, pp. 89-96. Elsevier 10.1016/j.avsg.2017.10.019

[img] Text
1-s2.0-S0890509617311287-main.pdf - Published Version
Restricted to registered users only
Available under License Publisher holds Copyright.

Download (1MB) | Request a copy

BACKGROUND Popliteal vessel injuries are associated with traumatic knee injury often requiring emergency revascularization. Medial and posterior approaches to the popliteal space have been proposed. This study evaluates the outcome of patients treated for traumatic popliteal vessel injuries via a posterior approach. METHODS Consecutive patients with traumatic vascular injuries in the popliteal segments II and III undergoing surgical repair via a posterior approach between October 2008 and December 2016 were analyzed. The level of the arterial injury was preoperatively confirmed by computed tomography angiography or duplex ultrasound. Surgery was performed in prone position. Perioperative and long-term outcomes were analyzed including a survey of all patients in January 2017 assessing survival, limb salvage, and claudication. RESULTS Ten patients (8 female; median age 66 years, range 22-88) with blunt knee trauma were identified, 8 of them after spontaneous knee dislocation. Five patients had local intimal disruption and 5 had complete transection of the popliteal artery. In 6 patients, an interposition graft (vein n = 5; xenograft n = 1) was used for revascularization. Two patients underwent direct reanastomosis and in 2 patients longitudinal arteriotomy with patch plasty was performed. All arterial reconstructions were patent at discharge. Two patients had additional transection of the popliteal vein; in one, reconstruction was performed by direct reanastomosis and in another by interposition of a vein graft. The latter had asymptomatic early postoperative occlusion of the vein graft. After a median follow-up of 56 months (range 45-99), no death, limb loss, or claudication was observed. CONCLUSIONS After traumatic knee injury, posterior approach to the popliteal vessels is feasible and effective. It allows revascularization by direct repair or a short segment interposition graft avoiding long distance bypass. A high limb salvage rate can be achieved with excellent long-term outcomes.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiovascular Surgery

UniBE Contributor:

Makaloski, Vladimir; Wyss, Dörte; Weiss, Salome; Becker, Daniel; Wyss, Thomas and Schmidli, Jürg

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1615-5947

Publisher:

Elsevier

Language:

English

Submitter:

Daniela Huber

Date Deposited:

24 Jan 2018 15:29

Last Modified:

22 Oct 2019 18:41

Publisher DOI:

10.1016/j.avsg.2017.10.019

PubMed ID:

29217442

BORIS DOI:

10.7892/boris.109972

URI:

https://boris.unibe.ch/id/eprint/109972

Actions (login required)

Edit item Edit item
Provide Feedback