Acute lower limb ischemia caused by penetrating vascular injury in the infrapopliteal fossa is uncommon in everyday practice and is associated with high amputation rates.
We report the case of a 62-year-old male with an infrageniculate popliteal penetrating arterial injury due to single gunshot trauma. The bullet entry wound was in the upper external tibial region, fractured the head and neck of the fibula bone, and transverse oblique posterior to tibial tuberosity, completely transecting the 3rd part of popliteal artery just above arterial trifurcation, and exiting in the middle medial calf region.
Digital subtraction angiography revealed completely arterial infrageniculate discontinuation with delayed collateral recanalization of posterior tibial artery in middle tibial region. The patient underwent emergency revascularization with the use of a reversed saphenous vein bypass graft. The patient had uneventful recovery and 6 months postoperatively at the follow up remains well with no reported complications.
Stamatatos I, Dimitriadis I, Metaxas E, Lioumpas D, Ralli S, Ispanopoulou S, Tzagkarakis F, Georgoudi S, Minardos I, Anagnostopoulos G and Rogdakis A
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