Korean J Thorac Cardiovasc Surg.  2007 Feb;40(2):136-139.

Bilateral Popliteal Artery Entrapment Syndrome

• Park CB
• Yoo DG
• Kim CW

Abstract

Bilateral popliteal artery entrapment syndrome is a rare vascular disease, which leads to ischemic claudication as a result of disturbance to the blood flow from the abnormal relationship of the popliteal artery to the gastrocnemius muscle, a fibrous band or the popliteus muscle in the young male population. A 58-years-old male patient, complaining of ischemic claudication, coldness and 3rd toe gangrene of left leg of 1 month's duration was admitted to our institution. His left ankle-brachial index was decreased; therefore, a femoral artery angiography was performed, which revealed a total occlusion below the distal superficial femoral artery of the left leg. An EKG revealed atrial fibrillation, suggestive of a thromboembolism of the popliteal artery due to atrial fibrillation; therefore, Urokinase thrombolysis was attempted. After the Urokinase thrombolysis, popliteal artery entrapment syndrome was diagnosed, with MRI then performed for an anatomical diagnosis. The popliteal artery entrapment was type I, where the popliteal artery was displaced medial to the Gastrocnemius head. After complete removal of the popliteal artery aneurysm, interposition was performed with a contra lateral greater saphenous vein graft. A mild right popliteal artery aneurysm still remained, but surgery was not performed. Currently, the patent is surviving, without complications. Herein, the good results obtained for the surgical treatment of a severely affected leg, and the conservative treatment of a mildly affected leg, are reported.

Keyword

Thromboembolism; Peripheral vascular disease; Arrhythmia; Gangrene

MeSH Terms

Aneurysm
Angiography
Ankle Brachial Index
Arrhythmias, Cardiac
Atrial Fibrillation
Diagnosis
Electrocardiography
Femoral Artery
Gangrene
Head
Humans
Leg
Magnetic Resonance Imaging
Male
Muscle, Skeletal
Peripheral Vascular Diseases
Popliteal Artery*
Saphenous Vein
Thromboembolism
Toes
Transplants
Urokinase-Type Plasminogen Activator
Vascular Diseases
Urokinase-Type Plasminogen Activator