title: Endovascular repair of iatrogenic popliteal artery trauma.
abstract: OBJECTIVE
  To evaluate the outcome of the management of iatrogenic arterial injuries following knee arthroplasty using a primary endovascular approach.
  
  
  METHODS
  A detailed review of the management of all iatrogenic arterial injuries to the lower limb following total knee arthroplasty (TKA) referred to the Vascular Surgical Unit of a tertiary referral hospital between July 2005 and December 2007 identified from a prospectively maintained database.
  
  
  RESULTS
  Of the seven cases referred over a 30-month period, six patients underwent endovascular treatment with successful limb salvage. All seven injuries were related to the popliteal artery behind the knee: pseudoaneurysm (4), intimal flap occlusion (2) and stenosis (1). One patient underwent above-knee amputation. The presentation and pattern of arterial injuries, potential risk factors for their occurrence, measures to reduce their risk and factors that aid in their early recognition are discussed.
  
  
  CONCLUSIONS
  An endovascular approach may be considered for the management of these injuries, although it is likely to involve long-term surveillance and may not be appropriate for all cases. Surgeons performing TKA should be aware of the potential risk factors for arterial injury and maintain a high index of suspicion for these infrequent injuries during the post-operative period.
authors.affiliation: Royal Derby Hospital, Derby, DE22 3NE, UK. jhsaunders@doctors.org.uk.
authors.forename: J H
authors.initials: JH
authors.lastname: Saunders
authors.affiliation: Royal Derby Hospital, Derby, DE22 3NE, UK.
authors.forename: S
authors.initials: S
authors.lastname: Subramonia
authors.affiliation: Department of Vascular Surgery, University Hospital, Queen's Medical Centre, Nottingham, NG7 2UH, UK.
authors.forename: W G
authors.initials: WG
authors.lastname: Tennant
keywords: Endovascular; Iatrogenic; Knee arthroplasty; Popliteal artery injuries; Vascular trauma
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