2019 Vol. 4 No. 1: 5 Case Report iMedPub Journals 1 © Under License of Creative Commons Attribution 3.0 License | This arcle is available from: hp://vascular-endovascular-surgery.imedpub.com/ www.imedpub.com Journal of Vascular and Endovascular Therapy Stamatatos I 1* , Dimitriadis I 2 , Metaxas E 3 , Lioumpas D 3 , Ralli S 4 , Ispanopoulou S 5 , Tzagkarakis F 2 , Georgoudi S 4 , Minardos I 5 , Anagnostopoulos G 2 and Rogdakis A 2 1 Department of Vascular and Endovascular Surgery, General Hospital Nikaia, Greece 2 Department of General Surgery, General Hospital Nikaia, Greece 3 Cardiothoracic Surgery Department, General Hospital Nikaia, Greece 4 Anaesthesiology Department, General Hospital Nikaia, Greece 5 Radiology and Imaging Department, General Hospital Nikaia, Greece * Corresponding author: Ioannis Stamatatos*  jeanhipp56@gmail.com Department of Vascular and Endovascular Surgery, General Hospital Nikaia, Greece Citaon: Stamatatos I, Dimitriadis I, Metaxas E, Lioumpas D, Ralli S, et al. Infrageniculate Popliteal Artery Injury Due to Single Gunshot Penetrang Trauma. J Vasc Endovasc Therapy. 2019, Vol.4 No.1:5. Introducon Peripheral arterial injuries may result from penetrang or blunt trauma to the extremies. If not recognized and treated rapidly, may have disastrous consequences resulng in the loss of life and limb. The incidence of arterial injuries below the popliteal fossa is difficult to determine because most of these injuries, when isolated, cause no vascular compromise. Acute lower limb ischemia caused by penetrang vascular injury in the infrapopliteal fossa is uncommon in everyday pracce and is associated with high amputaon rates. Case Presentaon A 62-year-old male paent presented in the emergency department due to penetrang leſt lower limb gunshot injury. He was tachycardic but normotensive with no signs of acve external bleeding. Bullet entry wound was in the upper external bial region, fractured the head and neck of the fibula bone, and transverse oblique posterior to bial tuberosity, completely transecng the 3 rd part of popliteal artery just above bioperoneal trunk, and exing wound located in the middle medial calf region (Figure 1). Clinically reduced mobility and par aesthesia with coolness was Infrageniculate Popliteal Artery Injury Due to Single Gunshot Penetrang Trauma Abstract Acute lower limb ischemia caused by penetrang vascular injury in the infrapopliteal fossa is uncommon in everyday pracce and is associated with high amputaon rates. We report the case of a 62-year-old male with an infrageniculate popliteal penetrang arterial injury due to single gunshot trauma. The bullet entry wound was in the upper external bial region, fractured the head and neck of the fibula bone, and transverse oblique posterior to bial tuberosity, completely transecng the 3 rd part of popliteal artery just above arterial trifurcaon, and exing in the middle medial calf region. Digital subtracon angiography revealed completely arterial infrageniculate disconnuaon with delayed collateral recanalizaon of posterior bial artery in middle bial region. The paent underwent emergency revascularizaon with the use of a reversed saphenous vein bypass graſt. The paent had unevenul recovery and 6 months postoperavely at the follow up remains well with no reported complicaons. Keywords: Penetrang arterial injury; Infrageniculate trauma; Peripheral vascular trauma Received: January 29, 2019; Accepted: February 13, 2019; Published: February 20, 2019 noced. Popliteal and bial arteries below the knee were non- palpable, whereas arteries of the contralateral lower limb were palpable throughout its enre length. Hand Doppler device revealed a monophasic waveform through the posterior bial artery at the level of medial malleolus, with an ankle brachial index (ABI) of 0.20. Paent underwent an emergency digital subtracon angiography