Popliteal pseudoaneurysm from suspected mechanical stress injury secondary to stent fracture and perforation: A case report

Popliteal artery aneurysms may be divided into true and false aneurysms (pseudoaneurysms). We present a case of a right popliteal pseudoaneurysm. A 67-year-old male presented to the hospital with significant pain in the right calf. A peripheral angiogram revealed extensive stent thrombosis in the right lower extremity. A thrombectomy and balloon angioplasty were done to reestablish blood flow. 2 weeks later the patient presented after a driving trip, with a peripheral angiogram revealing a popliteal pseudoaneurysm. Vascular intervention was performed, replacing the right popliteal artery with a 6 mm polytetrafluoroethylene graft. There is a high degree of suspicion for mechanical stress injury from prolonged knee flexion. The etiology of the pseudoaneurysm was most likely from mechanical stress, despite its historical association with true aneurysms. Although differentiating between true and false aneurysms is important in determining etiology, these are not all-inclusive and overlap of causation may occur.