Gunshot-Induced Popliteal Artery Pseudoaneurysm: A Case Report.

Popliteal artery injuries are uncommon but carry a high risk of limb-threatening complications. Among these, pseudoaneurysms caused by penetrating trauma, such as gunshot wounds, are particularly rare and clinically significant due to their potential for delayed presentation and high morbidity. We report the case of a 46-year-old male who sustained a gunshot wound to the left thigh. CT angiography revealed a pseudoaneurysm with >50% transection of the popliteal artery. Urgent surgical repair with thrombectomy and polytetrafluoroethylene graft placement led to full neurovascular recovery. This case underscores the limitations of relying solely on clinical examination to rule out vascular injury, as distal pulses may remain intact despite significant arterial compromise. Clinicians should maintain a high index of suspicion and promptly employ imaging, especially CT angiography, in any equivocal or evolving limb trauma. The delayed onset of ischemic and neurological signs highlights the importance of maintaining a high index of suspicion and utilizing CT angiography in equivocal cases. Prompt recognition and surgical intervention, supported by advances in imaging techniques and vascular graft materials, are key to preventing irreversible damage and optimizing limb salvage outcomes.