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58 year old TKR patient treated for large post-operative aneurysm in the Popliteal Artery

On 1st April 2019, 58 year old female patient Basanti Dhar underwent a corrective procedure for a large aneurysm in the popliteal artery of her left leg under Dr. Asok Dhar, Senior Consultant of the Department of Cardiac Sciences at Fortis Hospital Anandapur.

The patient first consulted at Fortis Hospital Anandapur with complaints of pain in both knees along with deformities at the knee. Post examination, she was diagnosed to be suffering from advanced osteoarthritis in both her knees and was advised to undergo a Total Knee Replacement surgery. As advised, she got admitted to the hospital on 31st March 2019 and underwent a TKR procedure on 1st April 2019, under Spinal Anaesthesia and Femoral Nerve Block.

However, in the post-operative period, extensive oozing was found from the wound site. A CT Angiogram revealed a large pseudo aneurysm at the left popliteal region communicating with the left popliteal artery. This aneurysm was caused due to continued leakage of blood from a branch of an artery, which was injured during the knee replacement procedure. Based on the reports of angiogram, the source of supply to the aneurism was identified and the correction procedure was conducted on 9th April 2019. The branch was first occluded with a stainless steel coil followed by deployment of a stent graft, covering the site of injury. The aneurysm was thus isolated from the main blood stream. This was followed by stoppage of the external surface bleeding as well. The aneurysm, gradually, became smaller and then disappeared within the next 24-48 hours.

Popliteal Artery Aneurysms (PAAs) represent the second most common peripheral arterial aneurysms following those located in the aortoiliac segment. They account for approximately 70% of all peripheral aneurysms with an incidence estimated to be less than 0.1%.    

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