Traumatic P2 popliteal artery pseudoaneurysm following penetrating injury: Open repair with autologous saphenous vein graft via medial approach

Title : Traumatic P2 popliteal artery pseudoaneurysm following penetrating injury: Open repair with autologous saphenous vein graft via medial approach

Abstract:

Popliteal vascular trauma is an uncommon but highly complex condition associated with significant morbidity, risk of permanent disability, and potential limb loss, substantially impacting patients’ quality of life. One of the most serious complications is traumatic pseudoaneurysm of the popliteal artery, particularly following penetrating injuries. Early recognition and timely management are crucial to prevent irreversible functional sequelae.

We report the case of a 31-year-old male who developed a pseudoaneurysm of the P2 segment of the left popliteal artery following a penetrating stab wound. Diagnosis was established through vascular imaging, confirming the presence of a contained pseudoaneurysm. The patient underwent open surgical repair using a medial approach. Intraoperatively, the affected arterial segment was resected and vascular continuity was restored with an inverted autologous great saphenous vein graft. The postoperative course was favorable, with preservation of limb perfusion and no immediate complications.

The medial approach is commonly used for injuries involving the P2 segment of the popliteal artery due to its adequate anatomical exposure and lower risk of associated neurological injury. However, in selected cases, the posterior approach has also demonstrated favorable outcomes. In recent years, endovascular management has emerged as a less invasive alternative for selected patients, particularly those with significant comorbidities or contained pseudoaneurysms. Nevertheless, this approach may be associated with complications such as stent thrombosis or migration.

Management of traumatic popliteal pseudoaneurysms should be individualized based on the location of the lesion, patient clinical status, and available institutional resources. Early diagnosis and a multidisciplinary approach are essential to optimize limb preservation and improve functional outcomes.

Biography:

Ashly Castro Contreras is a medical student with a strong interest in surgery, particularly vascular and trauma surgery. She is actively involved in academic and research activities, including participation in surgical interest groups and clinical case presentations. Her work focuses on the surgical management of complex vascular injuries and aims to contribute to improved patient outcomes through evidence-based practice