Korean J Sports Med.  2013 Jun;31(1):26-29. 10.5763/kjsm.2013.31.1.26.

Clinical Bilateral Poplitear Artery Entrapment Syndrome Caused by a Anomalous Origin of the Gastrocnemius Muscle

• Park HG
• Yun SH
• Kim SJ

• KMID: 1838970
• DOI: http://doi.org/10.5763/kjsm.2013.31.1.26

Abstract

Popliteal artery entrapment syndrome can result from abnormal branching patterns of the popliteal artery or the anatomically abnormal placement of nearby muscles and tendons leading to a sustained compression of the popliteal artery. This compression leads to chronic capillary damage and early arteriosclerosis and embolism that can lead to distal ischemia. Thus early treatment is required to prevent harm to the lower limb. This is a rare congenital disease that mostly affects young adults, usually presenting with intermittent claudication of the leg, coldness and edema. A case where a 16-year-old female presented with pain and coldness in the lower right limb that started 1 year ago will be discussed. In this case, magnetic resonance imaging and arterial angiography lead to a diagnosis of popliteal artery entrapment resulting from an abnormal origin of the medial head of Gastrocnemius.

Keyword

Popliteal artery; Entrapment syndrome

MeSH Terms

Angiography
Arteries
Arteriosclerosis
Capillaries
Cold Temperature
Edema
Embolism
Extremities
Female
Head
Humans
Intermittent Claudication
Ischemia
Leg
Lower Extremity
Magnetic Resonance Imaging
Muscle, Skeletal
Muscles
Popliteal Artery
Tendons
Young Adult

Figure

• 

  Fig. 1. Popliteal artery entrapment resulting from an abnormal origin of the medial head of gastrocnemius, arising from supracondylar region, passing between popliteal artery and vein and inserting into medial head of muscle.

• 

  Fig. 2. Nearly complete segmental occlusion in the right popliteal artery at the superior aspect of femoral condyle.

• 

  Fig. 3. Right deviated arterial structure is narrower than other portion.

Reference

References

1. Rich NM, Hughes CW. Popliteal artery and vein entrapment. Am J Surg. 1967; 113:696–8.

2. Delaney TA, Gonzalez LL. Occlusion of popliteal artery due to muscular entrapment. Surgery. 1971; 69:97–101.

3. Bouhoutsos J, Daskalakis E. Muscular abnormalities affecting the popliteal vessels. Br J Surg. 1981; 68:501–6.

4. Stuart TP. Note on a variation in the course of the popliteal artery. J Anat Physiol. 1879; 13:162.

5. Whelan TJ, Haimovici H. Vascular surgery: principles and technizues. 2nd ed.New York: McGraw-Hill;1984.

6. Rich NM, Collins GJ Jr, McDonald PT, Kozloff L, Clagett GP, Collins JT. Popliteal vascular entrapment: its increasing interest. Arch Surg. 1979; 114:1377–84.

7. di Marzo L, Cavallaro A, Sciacca V, Mingoli A, Stipa S. Natural history of entrapment of the popliteal artery. J Am Coll Surg. 1994; 178:553–6.

8. Fujiwara H, Sugano T, Fujii N. Popliteal artery entrapment syndrome: accurate morphological diagnosis utilizing MRI. J Cardiovasc Surg (Torino). 1992; 33:160–2.

9. di Marzo L, Cavallaro A, Sciacca V, Mingoli A, Tamburelli A. Surgical treatment of popliteal artery entrapment syndrome: a ten-year experience. Eur J Vasc Surg. 1991; 5:59–64.