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

## TL;DR

A woman developed a rare blood vessel abnormality in her knee eight years after surgery and was treated with a special stent, which remained effective for five years.

## Contribution

This paper presents a rare case of a long-delayed arteriovenous fistula after knee surgery and its successful endovascular treatment.

## Key findings

- A popliteal arteriovenous fistula was diagnosed eight years after total knee arthroplasty.
- Endovascular treatment with a Viabahn® stent was effective and remained intact for five years.
- Early detection of pseudoaneurysms and fistulas is emphasized for better outcomes.

## Abstract

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®) 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.