2021 Volume 30 Issue 4 Pages 201-204
Total knee arthroplasty (TKA) is a relatively safe surgical procedure, but arterial injury has been reported as a rare complication. A 73-year-old woman presented with swelling in her left lower limb two weeks after left TKA. Her symptoms gradually worsened, and she was referred to our hospital 101 days later. Contrast-enhanced CT showed a giant hematoma of about 12×18 cm in size from the popliteal to the posterior side of the lower limb, and angiography revealed leakage of the contrast medium behind the popliteal artery. She was diagnosed with a pseudoaneurysm of the left popliteal artery caused by TKA. Endovascular repair was performed using a VIABAHN stentgraft placed at the perforation site of the popliteal artery, and hematoma drainage was performed simultaneously. The postoperative course was uneventful and she was discharged 11 days after the operation. The 6-month follow-up angiography showed no contrast staining within the wall of the pseudoaneurysm and no significant stenosis in the popliteal artery. The patient has been asymptomatic for 36 months since the operation. Stentgraft insertion for the popliteal artery is not covered by insurance, but may be an effective treatment in some cases.
