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Popliteal artery injuries are very rare (4% of all vascular injuries).
The majority of injuries are secondary to penetrating injury (70+%)
Blunt mechanism of injury has the higher rate of amputation.
Prolonged ischemia time (from injury to repair greater than 6 hours) leads to higher rates of amputation
Hard signs of vascular injury should prompt X-ray imaging of the knee, femur, and lower extremity and transfer to an operating room for repair.
Soft signs ("a history of significant bleeding which has ceased, nonexpanding hematomas, and the presence of an Ankle-Brachial Index of less than 0.9") and shotgun injury should prompt CT angiogram to evaluate arterial injury.
References
Asensio, Juan A. MD, PhD, DABS, FACS, FCCM, FRCS (England), FSVS, FAIM, FISS, KM; Ceron, Santiago A. MD; Inyang, Ime D. BA; Johnson, Sarah E. DHSc, MS; Williams, Mallory MD, MPH, FACS, FICS, FCCP, FCCM; Velasco, Jose M. MD, FACS, FCCM. Popliteal artery injuries: What you need to know. Journal of Trauma and Acute Care Surgery 100(2):p 162-172, February 2026. | DOI: 10.1097/TA.0000000000004752