Arterial occlusion after total knee arthroplasty is an uncommon complication. In the literature only a few cases have been reported, and non consensus exists on the optimal management for this condition. The authors report two patients with popliteal artery thrombosis in the early postoperative period. Both patients were treated with percutaneous thrombus aspiration, a technique that has not been reported previously for this indication. In both patients complete restoration of arterial perfusion and limb salvage was achieved, although ischemic necrosis of the anterior compartment muscles of the lower leg could not be prevented.