What question did this study set out to answer?

This study aims to evaluate the effectiveness and complications of open surgical repair versus endovascular repair for popliteal artery injuries.

March 14, 2026Open Access

Treatment of popliteal artery injuries: a comparison of application patterns and short-term outcomes between open surgical and endovascular repair

Key Points

This study aims to evaluate the effectiveness and complications of open surgical repair versus endovascular repair for popliteal artery injuries.
Conducted a single-center retrospective cohort study from 2022–2024.
Enrolled 140 patients with peripheral arterial injury treated surgically.
Stratified participants into endovascular (n=41) and open surgical repair (n=99) groups.
Analyzed parameters like limb salvage rate, blood loss, operative duration, and VAS scores.
No significant difference in 6-month limb salvage and short-term patency rates between groups (P > 0.05).
Open surgery had greater intraoperative blood loss (464.60 ml) compared to endovascular (175.46 ml).
Average surgical duration was longer for open surgery (128.89 min) versus endovascular (104.34 min).
Complication rates were similar with open surgery at 27.27% and endovascular at 21.95%, but amputation rates were lower in the endovascular group (4.88%).

Abstract

After femoral artery injury, popliteal artery injury (PAI) is the second most frequent form of arterial injury in the lower extremities. Its exceptionally high risk of limb loss has attracted a lot of attention in the field of acute lower extremity vascular damage. Nowadays, open surgical repair or endovascular surgical repair are the main methods used to treat popliteal artery damage due to developments in medical technology. The effectiveness and complication rates of these two surgical techniques are still hotly debated, though, and there is a lot of room for advancement in this field. The purpose of this study was to compare the clinical effectiveness of endovascular surgery versus open surgery for PAI, list the benefits and drawbacks of each procedure, and offer recommendations for clinical decision-making. This single-center retrospective cohort study (2022–2024) enrolled 140 patients with peripheral arterial injury (PAI) who underwent surgical treatment at our institution. Participants were stratified into two groups according to surgical approach: endovascular repair (n = 41) and open surgical repair (n = 99). The following parameters were analyzed and compared between groups: limb salvage rate, intraoperative blood loss, operative duration, preoperative and postoperative Visual Analog Scale (VAS) scores, complication rates, and secondary intervention rates. The prespecified primary endpoint was the 6-month limb salvage rate. All statistical analyses were performed using SPSS version 27.0, with a P value 0.05), although there were significant variations in surgical length, blood loss, and postoperative VAS ratings (P 0.05). This study shows similar limb salvage and short-term patency between endovascular and open repair for popliteal artery injuries. Endovascular approach offers minimally invasive benefits without reducing complications. The retrospective design risks bias and limits follow-up, with open repair possibly including more complex cases. These findings should be confirmed through prospective multicenter trials with standardized outcomes.

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