Abstract
Purpose To explore the impact of different levels of popliteal artery injury (PAI) on the risk of amputation in affected limbs.Method 94 patients were divided into the amputation group (n = 26) and the nonamputation group (n = 68) based on whether limb preservation was successful. The data was reconstructed from computed tomography angiography (CTA) of the patient's lower limbs and measured using AW Volume Share 5 software. Quantify the height of the popliteal artery injury plane: that is, the distance L from the bifurcation of the descending knee artery on the healthy limb to the bifurcation of the anterior tibial artery and the distance S from the bifurcation of the descending knee artery at the site of blood flow interruption on the affected limb. Take the ratio of R = S/L, where S and R represent the height of the blood flow interruption plane. Analyze the risk factors affecting amputation in two groups of PAI patients .Result There were an significant difference between R and S between the two groups;Univariate and multivariate logistic regression analysis showed that R (OR = 0.923, P = 0.015), S (OR = 0.712, P = 0.036), ischemic time (OR = 1.237, P = 0.004), and concurrent fascial compartment syndrome (OR = 5.496, P = 0.044) were all independent risk factors for amputation in PAI patients. Receiver operating characteristic curves of the subjects showed that the AUC (R, S) were 0.896 (P < 0.000, 95% CI: 0.816–0.949) and 0.775 (P < 0.000, 95% CI: 0.677–0.854), respectively; The diagnostic efficiency is highest when the diagnostic threshold values are 0.522mm and 11.4mm, respectively; AUCR>AUCS (Z = 1.974, P = 0.0484).Conclusion The level of injury is an independent risk factor for amputation in PAI patients, and the higher the level of injury, the greater the risk of amputation. In terms of evaluating the diagnostic efficiency of the injury plane in predicting amputation risk, R is superior to S.