目的 评价创伤性腘动脉损伤的腔内修复效果和治疗经验.方法 回顾性分析2010年1月～2017年2月我院收治的21例创伤性腘动脉损伤患者资料.男18例,女3例;年龄23～64岁,平均(37.8±11.9)岁.致伤原因包括交通伤9例,机器挤压伤4例,坠落伤3例,重物砸伤3例,医源性损伤1例,锐器伤1例.患者术前行彩色多普勒超声或CT血管造影显示腘动脉损伤情况,并经术中动脉造影确诊,选择覆膜支架、裸支架或裸支架辅助弹簧圈栓塞方法行腔内修复治疗.结果 21例患者手术成功率100％,腔内修复治疗后立刻重建血流通道,腘动脉损伤段管腔血流通畅,破口被完全隔绝,无对比剂滞留、外溢.围手术期并发症3例,其中1例为胫后动脉穿刺点血肿,2例为术后患肢出现骨筋膜室综合征,分别给予对症处理后恢复良好.21例获随访6～50个月,平均(23.2±12.1)个月,1例支架腔内狭窄>50％,予以球囊扩张治疗后支架内血流恢复通畅;其余移植物在随访期内通畅.结论 腔内修复治疗创伤性腘动脉损伤近、中期效果好,是一种安全、可行的方法.%Objective To evaluate the efficacy of endovascular repair of popliteal artery injuries . Methods The clinical data of 21 patients ( 18 men , 3 women , age range: 23-64 years , mean: 37 . 8 ± 11 . 9 years ) with popliteal artery injuries treated at our hospital from January 2010 to February 2017 were retrospectively analyzed . The types of trauma included motor vehicle acci-dent ( 9 ) , machine crush ( 4 ) , fall from heights ( 3 ) , impact by falling object ( 3 ) , stab wound ( 1 ) , and iatrogenic injury ( 1 ) . Ultra-sound or CT angiography was performed prior to endovascular repair using covered stent , bare-metal stent , or stent-assisted coil . Results Endovascular repair was successful on all patients with reconstruction of the blood flow channels , recovery of popliteal artery blood flow , isolation of the puncture in the artery , and no contrast extravasation . Perioperative complication included hematoma in the posterior tibial artery puncture site ( 1 ) and compartment syndrome ( 2 ) with recovery after symptomatic treatment . At 6-50 month follow-up ( mean duration: 23 . 2 ± 12 . 1 months ) , 1 patient with greater than 50％stent stenosis required second balloon dilation. All other grafts remained patent. Conclusion Endovascular treatment of popliteal artery injuries is safe and effective in short-to mid-term follow-up.
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