title: Popliteal venotomy during posterior cruciate ligament reconstruction in the setting of a popliteal artery bypass graft.
abstract: Injury to the vascular structures in the popliteal fossa during arthroscopic cruciate ligament reconstruction can be limb threatening or even life threatening. We present the first report, to our knowledge, of an isolated injury to a popliteal vein during arthroscopic posterior cruciate ligament reconstruction. Unfortunately, the venotomy led to cardiopulmonary arrest and flash pulmonary edema in this patient. Preoperative planning is paramount to assess risk of injury to vascular structures, which may be increased in patients who have had prior procedures on the affected knee. Furthermore, vascular surgery consultation preoperatively after a magnetic resonance angiogram or venogram and avoiding the use of epinephrine in the arthroscopy fluid should be considered when performing these higher-risk procedures.
authors.affiliation: Hospital for Special Surgery, New York, New York 10021, USA. nemaniv@hss.edu
authors.forename: Venu M
authors.initials: VM
authors.lastname: Nemani
authors.forename: Rachel M
authors.initials: RM
authors.lastname: Frank
authors.forename: Keith R
authors.initials: KR
authors.lastname: Reinhardt
authors.forename: Cecilia
authors.initials: C
authors.lastname: Pascual-Garrido
authors.forename: Adam B
authors.initials: AB
authors.lastname: Yanke
authors.forename: Mark
authors.initials: M
authors.lastname: Drakos
authors.forename: Russell F
authors.initials: RF
authors.lastname: Warren
mesh_terms: D001182:Arthroscopy / Q000009:adverse effects*; D005260:Female; D006323:Heart Arrest / Q000209:etiology*; D006801:Humans; D007431:Intraoperative Complications; D011150:Popliteal Artery / Q000601:surgery*; D011152:Popliteal Vein / Q000293:injuries*; D016119:Posterior Cruciate Ligament / Q000293:injuries / Q000601:surgery*; D011654:Pulmonary Edema / Q000209:etiology; D019651:Plastic Surgery Procedures / Q000009:adverse effects*; D014656:Vascular Surgical Procedures / Q000009:adverse effects*; D055815:Young Adult