Vein Graft Characteristics and Clinical Outcomes in Blunt Popliteal Artery Injury: A Retrospective Case Series

Blunt popliteal artery injury (PAI) often requires complex vascular reconstruction because of extensive arterial damage. However, the frequency of vein graft use, required graft length, and their association with clinical outcomes remain unclear. This study aimed to evaluate vein graft characteristics and clinical outcomes in blunt PAI.

We retrospectively reviewed patients with blunt PAI treated at a single trauma center. Patient demographics, mechanism of injury, reconstruction method, vein graft length, soft tissue reconstruction, and amputation were investigated. Severe soft tissue injury was defined as cases requiring flap reconstruction or lower extremity amputation. The association between vein graft length and severe soft tissue injury was analyzed using the Mann-Whitney U-test.

Twenty-four limbs underwent popliteal artery reconstruction. Vein graft reconstruction was required in 20 cases (83.3%), whereas 4 cases underwent primary end-to-end anastomosis. Median vein graft length was 6.0 cm (range, 4-12 cm). Technical success of revascularization was achieved in all cases, and no recurrent limb ischemia was observed during follow-up. Among patients treated with vein graft reconstruction, 4 required soft tissue reconstruction and 2 underwent below-knee amputation. Patients with severe soft tissue injury tended to require longer vein grafts than those without severe soft tissue injury (median, 9.0 cm vs. 5.5 cm; P = 0.10).

Vein graft reconstruction is frequently required in blunt PAI, with a median graft length of 6.0 cm. Patients with severe soft tissue injury tended to require longer vein grafts than those without severe soft tissue injury; however, this association did not reach statistical significance and should be considered hypothesis-generating.