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PubMedDate not supplied

Popliteal artery thrombosis in a young woman, secondary to bony exostosis.

Idiopathic thrombosis of the popliteal artery in young people is exceedingly uncommon. Previously suggested etiologies are cystic adventitial disease, popliteal entrapment syndrome, Buerger's Disease, juvenile arteriosclerosis and synovial cysts. An instance of popliteal artery thrombosis secondary to compression by a bony exostosis is recorded to call attention to this unusual etiological mechanism in a 21 year old woman. Restoration of arterial continuity was achieved by endarterectomy and a venous patch graft following excision of the bony exostosis.

Adult↗
PubMed1987

Popliteal artery trauma: a high risk injury.

The clinical presentation and management of 28 popliteal artery injuries following penetrating and blunt trauma during a 6 year period is reviewed. Clinical and Doppler evaluation identified an arterial injury in 24 (85 per cent) patients. In eight (29 per cent) patients with arteriovenous fistulae or false aneurysms, pedal pulses were palpable during initial assessment. Three (10.7 per cent) patients had limb amputation attributable to delayed vascular repair, crush injury and sepsis. End-to-end arterial repair following blunt trauma resulted in early failure with thrombosis in two patients. Autogenous vein grafting was used in 12 patients and is advocated in all blunt popliteal arterial injuries. Routine repair of associated venous injuries and liberal criteria for early fasciotomy were used. Exoskeletal fixation or skeletal traction for compound and comminuted fractures is recommended for simplicity of application and wound management. The significant functional orthopaedic disability following blunt arterial trauma at the knee is emphasized.

Adolescent↗
PubMed2002

Treatment of complex arteriosclerotic lesions with nitinol stents in the superficial femoral and popliteal arteries: a midterm follow-up.

PURPOSE: To evaluate the effectiveness of nitinol stents in patients with short, complex lesions in the superficial femoral and popliteal arteries and to assess midterm results. MATERIALS AND METHODS: Self-expandable nitinol stents were implanted in 54 extremities in 44 patients to treat complex stenoses (n = 32) and occlusions (n = 22) in the superficial femoral and popliteal arteries. Follow-up was performed for 5-51 months to evaluate early thrombosis and midterm patency rates. Midterm patency rates were compared between the following: stenoses and occlusions, proximal and distal locations, good and poor runoff, and diabetic patients and nondiabetic patients. All patients underwent clinical investigation and color Doppler sonography after 1 month and 6 months and at 6-month intervals thereafter. If restenosis or stent thrombosis was suspected, intraarterial digital subtraction angiography of the superficial and popliteal arteries was performed. RESULTS: Percutaneous stent implantation was successful in all patients. The mean duration of follow-up was 27 months (range, 5-51 months). No thrombotic occlusion occurred within the first 4 weeks after stent implantation. The primary 3-year patency rate was 76%, and the secondary patency rate was 87%. Three-year primary patency rates were 65% for diabetic patients and 82% for nondiabetic patients. CONCLUSION: In patients with short, complex stenoses and occlusions, implantation of nitinol stents may have a positive impact on midterm results.

Aged↗
PubMed1993

Popliteal artery aneurysm. Prompt intervention prevents tragic consequences.

Popliteal artery aneurysm is an important, if uncommon, cause of lower extremity ischemia. About half of cases are asymptomatic. Untreated aneurysms may lead to embolization, rupture, thrombosis, and amputation. Diagnosis involves careful physical examination and use of ultrasound and arteriography. Prompt surgical intervention is essential.

Aged↗
PubMed1999

Popliteal artery pseudo-aneurysm following penetrating trauma.

Popliteal artery pseudo-aneurysm due to accidental penetrating trauma, once common during world wars, is now rare. It may require amputation due to ischaemic complication. One such case is detailed here. The angiographic findings, complications, management and literature review are provided.

Adult↗
PubMed2003

Long-term outcome of femoral above-knee popliteal artery bypass using autologous saphenous vein versus expanded polytetrafluoroethylene grafts.

Despite a recent flurry of publications on preferred techniques for femoral above-knee popliteal artery bypass, controversy persists over the use of autologous saphenous vein and expanded polytetrafluoroethylene (ePTFE) grafts. The purpose of this study was to compare our long-term results using these two bypass materials. In a series of 474 infrainguinal bypasses performed between January 1993 and December 1998, we performed a total of 75 femoral above-knee popliteal artery bypass using an autologous saphenous vein graft in 48 cases (64%) and an ePTFE graft in 27 cases (36%). Prosthetic grafts were used by choice in 17 cases and by necessity due to the absence of useable vein in 10 cases. There were 55 men and 18 women with a mean age of 70 years. The indication for bypass was lower extremity arterial occlusive disease at stage II in 17 cases (22.7%), stage III in 9 cases (12%), and stage IV in 36 cases (48%); subacute ischemia in 8 cases (10.7%); and femoropopliteal aneurysm in 5 cases (6.7%). Preoperative arteriography demonstrated three patent leg arteries in 15.5% of cases, two patent leg arteries in 43.5%, and one patent leg artery in 41%. There was no significance difference between the vein graft and ePTFE graft groups with regard to indications and arteriographic findings. No patient died during the immediate postoperative period. The mean duration of follow-up was 25.5 months (range, 3 to 108 months). The primary patency rate at 4 years was 82.2 +/- 8% for venous bypass vs. 80.6 +/- 11.8% for ePTFE bypass (p = 0.42). The secondary patency rate at 4 years was 84.7 +/- 7.4% for vein bypasses and 79.5 +/- 12% for ePTFE bypasses (p = 0.26). In our experience, there was no statistically significant difference in long-term outcome of femoral above-knee popliteal artery bypass using autologous vein grafts or prosthetic ePTFE grafts.

Aged↗
PubMed1997

[Mechanical high speed analysis of acute thromboembolic occlusions of t he popliteal artery. Initial experiences with the Amplatz thrombectomy catheter].

PURPOSE: To determine the efficacy and the benefits of the Amplatz Thrombectomy Device (ATD) in acute thromboembolic occlusions of the popliteal artery. PATIENTS AND METHODS: 15 Patients (mean age 66 years) presenting with acute thromboembolic occlusions of the popliteal artery underwent mechanical thrombolysis with the ATD. The duration of symptoms was 1-22 days, mean length of occlusion was 7 cm (5-10 cm). RESULTS: Mechanical thrombolysis was successfully performed in 14/15 patients. The mean running time of the ATD was 4 minutes. The ATD failed in one patient with a 22-day history of popliteal artery occlusion. Remaining stenoses after ATD-thrombolysis were treated with percutaneous transluminal angioplasty (n = 3): pulse spray thrombolysis with urokinase was performed in two patients, in one patient aspiration thromboembolectomy with a 5F-catheter was performed to remove a small embolus from the anterior tibial artery. The ankle-brachial-index increased from 0.62 +/- 0.25 to 0.9 +/- 0.15. CONCLUSIONS: The ATD seems to be a safe, simple, and fast-acting mechanical device from mechanical thrombectomy in the lower limbs. No complications were seen.

Acute Disease↗
PubMed1988

Popliteal artery entrapment syndrome.

Two patients with unilateral popliteal artery entrapment syndrome (PAES) are reported. The importance of diligence in angiographic diagnosis and recognition of the so-called "functional" PAES group as a separate entity are stressed. It is inferred from our material that a surgical approach for PAES is to be advocated since surgical release of the entrapment can lead to complete resolution of symptoms regardless of aetiology.

Adult↗
PubMed1982

Injury to the popliteal artery.

During a 32 year period, 164 patients with 165 popliteal artery injuries were treated. One hundred twenty-five injuries were due to penetrating trauma, and 40 to blunt force. During the first decade reviewed, with ligation the main method of management, the amputation rate was 74 percent. Almost routine attempts at vascular repair over the ensuing 10 years reduced the amputation rate to 28 percent. During the final 12 years, six amputations were required for 81 injuries, thereby producing an amputation rate of only 6 percent. From this experience, the following principles of management have evolved: (1) early diagnosis is best accomplished by a careful history and detailed physical examination, not by arteriography; (2) thrombectomy followed by distal heparinization before repair is the best method for guaranteeing an adequate arterial outflow tract and thus successful revascularization; (3) resection of all injured vessels with reconstitution of continuity by the use of an interposed saphenous vein graft is often warranted to avoid tension; (4) popliteal vein repair should be performed when practical; and (5) subperiosteal fibulectomy-fasciotomy should be done routinely immediately after vascular repair.

Adolescent↗
PubMed2005

[Cystic adventitial degeneration of the popliteal artery; an unexpected cause of intermittent claudication].

Three men, aged 48, 44 and 51 years, were referred to the vascular surgery outpatient clinic because of acute intermittent claudication in one leg. The first patient had no medical history and no vascular risk factors, the second patient was receiving drug treatment for hypercholesterolaemia and diabetes mellitus and the third patient smoked. After additional radiological diagnostics, cystic adventitial degeneration of the popliteal artery was diagnosed in all patients. All 3 patients were operated. Only circumferential resection of the cystic adventitia and the outer layer of the media, so-called exarteriectomy, was performed in the second patient. The other 2 patients underwent resection of the affected popliteal artery followed by an autologous vein graft. The post-operative course was uncomplicated. The diagnosis of cystic adventitial degeneration was confirmed histopathologically. Cystic adventitial degeneration is localised only in the popliteal artery in 85-90% of cases. It is probably caused by incorporation of mesenchymal cells in the wall of the popliteal artery during embryogenesis. The disease is often progressive and, if left untreated, may lead to critical ischaemia due to arterial occlusion. Surgical intervention is therefore necessary, with exarteriectomy as the preferred technique, especially because the patients are often young.

Adult↗
PubMed2005

[Diagnosis and surgical treatment of aneurysms of the popliteal artery].

Nineteen patients with aneurysms of the popliteal artery have been operated. Indications and type of surgery were determined on the basis of the clinical picture, angiography and duplex scanning data. There were 19 surgeries: ligation of afferent and efferent vessels of aneurysm with auto-venous grafting (8), resection of aneurysm with auto-venous grafting (5), dissection of aneurysm with auto-venous grafting and coverage with duplication from aneurysmatic walls (3), endovascular grafting of aneurysm (2), ligation of afferent vessel of aneurysm (1). In early postoperative period after open surgical revascularizations thrombosis was seen in 4 (25%) patients. One patient died on day 20 after surgery due to decompensation of severe concomitant disease. The patient who has undergone ligation of afferent vessel without revascularization has discharged after compensation of acute ischemia.

Adult↗
PubMedDate not supplied

[Acute trauma to the popliteal artery].

In spite of the advances in reconstructive vascular surgery, acute trauma of the popliteal artery still results in a high percentage of amputations, around 30%. In a series of 33 traumas of the popliteal artery, at la Salpetriere Hospital, a marked predominance of contusions (28 cases) was recorded, with osteoarticular lesions representing the most frequent cause of these contusions. Two injured patients died at an early stage and 9 underwent an amputation. 22 injured patients were reconstructed and the immediate result was satisfactory. The need for early treatment, rapid transfer of the injured, admission to a specialized vascular surgery department and short but effective investigations, should be emphasized. From a therapeutic standpoint, venous repair is advisable and orthopaedic reconstruction must precede arterial repair. A venous graft is most often used for that purpose in cases of contusion, or resection-anastomosis in clean side-arm wounds.

Adolescent↗
PubMed2002

Surgical treatment for acute ischemia caused by bilateral popliteal artery entrapment syndrome in an elderly patient: report of a case.

We report the unusual case of a 73-year-old man who underwent surgery for bilateral popliteal artery entrapment syndrome (PAES). A medial approach was used to operate on the left leg, and the vein bypass was made from the superficial femoral artery to the crural artery through a subfascial route. A posterior approach was used to operate on the right leg and it was found that the mid-popliteal artery passed medial to and beneath the medial head of the gastrocnemius muscle and was severely compressed by an accessory slip of muscle. The vein bypass from the above-knee to below-knee popliteal artery was established through the original route after resection of the accessory slip of muscle. A postoperative arteriogram showed good bypass flow to the bilateral crural arteries. To our knowledge, this case represents the oldest patient with this disorder to be treated by surgery.

Aged↗
PubMed1975

Aneurysms of the popliteal artery.

Thirty-one aneurysms of the popliteal artery in 23 patients have been studied. Twenty-nine aneurysms were secondary to atherosclerosis, while one was secondary to trauma and one was associated with a coagulopathy. The lesions were bilateral in eight patients and were associated with extra-popliteal aneurysms in ten patients; the abdominal aorta was the most frequent extrapopliteal site. All except two of the 23 patients were over 50 years of age, and many exhibited atherosclerosis and related symptoms in other vessels. Ischemic rest pain was the most common presenting symptom in patients with popliteal aneurysm, but three of the patients were asymptomatic. The most common physical sign was a palpable popliteal mass in 25 patients, with impending gangrene distal to the aneurysm in four. Thrombosis occurred in 11 of the aneurysms, embolism in three, and rupture in two. Amputation was eventually necessary in five patients with thrombosis and in one patient with embolism. Of 16 patients presenting with a complication of popliteal aneurysm, six patients eventually required amputation. All popliteal aneurysms should be treated surgically and arterial continuity restored unless contraindicated by the over-all condition of the patient. The saphenous vein represents the optimal replacement material available at this time, but fabric grafts can be used successfully.

Adult↗
PubMedDate not supplied

[Aneurysm of the popliteal artery. Prognostic and therapeutic criteria].

Experience of the management of 45 patients affected by popliteal artery aneurysms is reported. All patients, but one, underwent operative treatment. The importance of immediate surgical reconstruction whenever a popliteal artery aneurysm has been detected is stressed. In fact the most frequent complication represented by sudden thrombosis of the aneurysmatic sac and/or by peripheral embolization is generally followed by an irreversible closure of the vascular run off, determining the high rate of failures (28% in our experience) in spite of a prompt surgical reconstructive procedure.

Aged↗