Popliteal Arteriovenous Fistula Diagnosed Eight Years after Total Knee Arthroplasty. Endovascular Treatment with Viabahn® Endoprosthesis and Five-Year Follow-Up

Background: Orthopedic surgery, while it rarely cause iatrogenic vascular lesions, leads to significant clinical, social, and economic consequences when it does. The knee is particularly susceptible to these injuries. Case Description: This case study presents the clinical case of a 71-year-old woman with a history of left total knee replacement. Eight years after the initial procedure, a popliteal-popliteal arteriovenous fistula was identified in the same knee. Given the location and caliber of the fistula, and despite the absence of symptoms, an endovascular prosthesis (Viabahn (R)) was deployed in the popliteal artery to cover the fistula. The prosthesis remained intact for the remainder of the patient's life, who succumbed to metastatic cancer five years later. Additionally, a review of the literature was conducted. Conclusion: This brief report describes an exceptional case of popliteal arteriovenous fistula, diagnosed eight years after a TKA, treated endovascularly and followed up over five years. Both pseudoaneurysms and arteriovenous fistulae should also be considered for early detection.