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At least 73 records · Page 4Linked to original sources
PubMed2003

Fate of excluded popliteal artery aneurysms.

OBJECTIVE: Popliteal artery aneurysms (PAA) are frequently treated with ligation and exclusion bypass grafting. It is assumed that these aneurysms will shrink and remain asymptomatic. This may not always be true. We sought to elucidate the fate of excluded PAA over time. METHODS: Data for all PAAs treated with ligation and exclusion bypass grafting between 1986 and 1999 were retrospectively reviewed. Computed tomography (CT) scans and duplex ultrasound scans provided aneurysm patency data and maximal transverse diameter measurements of the popliteal artery during late postoperative follow-up. This information was compared with that from similar preoperative studies. RESULTS: Forty-one patients (39 men, 2 women) underwent 57 ligation and exclusion bypass grafting procedures. Both preoperative and late postoperative (mean, 4.0 years; range, 0.43-13.5 years) CT scans or duplex ultrasound scans were available for review of 25 PAAs in 18 patients (ages 42-80 years; mean, 63 years). Preoperative PAA size ranged from 14 to 45 mm (mean, 28.7 mm). In late follow-up, 12 (48%) PAA had decreased in size (mean, 7.3 mm), 5 (20%) remained unchanged, and 8 (32%) increased in mean transverse diameter (mean, 5.9 mm). One large aneurysm increased by 50%. Contrast material enhancement was identified in the excluded sac in 11 aneurysms. CONCLUSIONS: PAA treated with ligation and exclusion bypass grafting often expand and can become symptomatic. This may be analogous to type II endoleak or endotension noted after aortic endovascular repair. We recommend PAA excision or endoaneurysmorrhaphy when feasible.

Adult↗
PubMed2001

Occlusion of the left common iliac artery and consecutive thromboembolism of the left popliteal artery following anterior lumbar interbody fusion.

We report on a case of occlusion of the left common iliac artery due to arteriosclerosis and consecutive thrombotic occlusion of the left popliteal artery in a 52-year-old man following anterior retroperitoneal interbody fusion of L4--S1. Initial symptoms included leg pain and numbness of the lateral shank, which were thought to be a result of lumbar nerve root irritation from surgery. Diagnosis was not made until 13 days after surgery, when motor deficits were observed. Angiography showed occlusion of the left common iliac artery and thromboembolism of the left popliteal artery. After thromboendarterectomy of the common iliac artery and thrombectomy of the popliteal artery, motor deficits of the left foot were resolved whereas symptoms of pain and sensory deficits continued. Spine surgeons should be aware of this rare complication in cases of postoperative leg pain or of neurologic deficits in the lower extremity after anterior lumbar interbody fusions.

Angiography↗
PubMedDate not supplied

Popliteal artery disease: diagnosis and treatment.

The popliteal artery is a relatively short vascular segment but is affected by a unique set of pathologic conditions. These conditions, which may be common throughout the arterial system or exclusive to the popliteal artery, include atherosclerosis, popliteal artery aneurysm, arterial embolus, trauma, popliteal artery entrapment syndrome, and cystic adventitial disease. The clinical manifestations, imaging appearances, and treatment options associated with these pathologic conditions differ significantly. Consequently, the radiologist should be familiar with these conditions to direct imaging for accurate diagnosis and treatment and to prevent loss of limb.

Adolescent↗
PubMed1999

Popliteal artery entrapment syndrome.

BACKGROUND: Popliteal artery entrapment syndrome (PAES) is rare and may be underdiagnosed. Improved specialized, non-invasive imaging techniques are producing detailed topographical evidence of the anomaly. METHODS: A historical review of the literature and Medline search was performed with reference to the diagnosis and treatment of the condition. In addition, embryologically based theories for the condition have been postulated. RESULTS AND CONCLUSION: PAES may be the result of abnormal development of the popliteal artery or a consequence of excessive cranial migration of the medial head of the gastrocnemius muscle. Magnetic resonance imaging appears to be the most useful single investigation to demonstrate the anomaly. Popliteal artery release alone or with vein bypass is the treatment of choice when intervention is indicated.

Arterial Occlusive Diseases↗
PubMed1988

[The type, scope and clinical relevance of early radiologic diagnosis of aneurysms of the popliteal artery].

The popliteal aneurysm as the cause of an acute arterial obliteration pattern is sometimes misinterpreted or overlooked. However, if a femoropopliteal aneurysm is confirmed, the therapeutic approach is substantially different. The article reports on the results of the radiological diagnosis of 17 popliteal aneurysms and the diagnostic relevance of the applied imaging processes is discussed. Real-time sonography and angiography complement each other in their findings and prove to be an indispensable part of preoperative diagnosis.

Aged↗
PubMed1989

Popliteal artery entrapment: an evolving syndrome.

Popliteal artery entrapment can result in claudication and limb-threatening ischemia in the young adult. The purpose of this study was to evaluate prospectively those patients with popliteal artery entrapment. To define the syndrome, the methods used in diagnosis and the type of anatomic anomaly were established for each patient. From 1977 to 1988, 12 patients were found to have popliteal artery entrapment. The average age was 27 years, with all but three patients under age 40 years. All patients complained of calf claudication, and one had acute ischemia. The ankle pulses decreased with maneuvers in 10 patients; four patients had a resting ankle/brachial index less than one. All had diminished ankle/brachial indexes when a treadmill test was performed at 4.2 mph, 10% grade, for 10 minutes. All patients had biplanar arteriography with passive dorsiflexion and active plantar flexion. All results showed abnormal extrinsic compression or occlusion of the popliteal artery. Twenty limbs were affected; eight of 12 patients (67%) had bilateral entrapment. Type IV (37%) lesions were the most common, with type II (32%) and type III (26%) following closely. One (5%) type I lesion and no type V lesions were found. This is the largest single series of patients with popliteal entrapment in the United States. A treadmill test followed by biplanar arteriography established the diagnosis in all patients. Bilateral involvement was twice that reported in previous studies. Popliteal artery entrapment should be considered in the young adult with claudication and may be seen with greater frequency in an increasingly active population.

Adult↗
PubMedDate not supplied

[Abnormal popliteal arteries].

Arteriopathy restricted to the popliteal artery, except in cases of atheroma, must indicate three of four unusual diagnoses: the trapped popliteal artery and the dessicating haematoma are anatomo-clinical entities that have been identified only relatively recently. The popliteal artery may be trapped by the medial gastrocnomius muscle, round the tendon of which the artery passes (totally or partially). This results in compression of the artery and eventually in thrombosis. Clinically, intermittent claudication is seen that may deteriorate and lead to gangrene of the toes. Arteriography makes it possible to diagnose the condition as the condition as the artery is considerably displaced inwards. Surgical correction is simple: sectioning of the tendon and repositioning of the artery. Dessicating haematoma of the popliteal artery is due essentially to atheroma, associated with medianecrosis. A "egg-timer" stenosis is found by arteriography and this condition also progresses towards thrombosis. Arterial restoration is called for, usually by bridging.

Adult↗
PubMed1991

Entrapment of the popliteal artery.

Although entrapment of the popliteal artery is uncommon, it is an important cause of arterial insufficiency in younger patients. Accurate diagnosis depends on a high index of suspicion combined with dynamic noninvasive testing and "stress angiography." Although angiographic demonstration of medial deviation of the artery is diagnostic, absence of this finding does not exclude the diagnosis of entrapment of the popliteal artery. Positional angiography may be necessary in these instances. Surgical exploration should be performed by a posterior approach, since this facilitates identification of the precise anatomic variant while allowing easy arterial repair, if necessary. The condition of the popliteal popliteal artery must dictate the extent of the surgical procedure. If the popliteal artery is normal, then relief of the constricting lesion alone will suffice. If the artery appears diseased or is thrombosed, then myotomy and arterial reconstruction must be performed. This is best accomplished by bypass grafting using autogenous vein or artery. If thromboendarterectomy is used, the clinician can expect a higher percentage of acute postoperative thromboses.

Adolescent↗
PubMed2002

[Popliteal artery entrapment syndrome. Case report].

Popliteal artery entrapment syndrome (PAES) is an uncommon pathological entity, due to segmental popliteal artery compression by the surrounding myofascial structures. Clinical symptoms may appear acutely, with temporary ischemic attacks, or chronically, with claudicatio intermittens of the involved calf and for 30% bilateral. Treatment, generally, is surgical by simple freeing of the popliteal artery from the surrounding myofascial structures or by autologous vein (saphenous v.) interposition grafting and patching, or bypass without vessel resection. The case of a 44-year female with left calf acute pain symptoms, cold skin at the thermotouch, hypo-paresthesia with fifth toe cyanosis and walking inability is reported. The surgical treatment, because of early diagnosis, consisted of simple cut of myofibrous bundle starting from the medial head of the left gastrocnemious muscle and compressing the popliteal artery, with clinical complete resolution.

Adult↗
PubMed2006

Management of popliteal artery aneurysms.

BACKGROUND: Popliteal artery aneurysms (PAA) are the most common peripheral aneurysm and are recognized as 'the silent killer of the leg circulation'. The timing and type of interventions used in their treatment is still controversial. This review examines the published data on the natural history, epidemiology, clinical presentation and management options available. The aim of this study is to try and reach a consensus with regards to the best management of PAA. METHOD: A systematic review of data in the English published works since 1980. RESULTS: The authors include 53 studies containing 2854 patients with 4291 PAA. Most published data involves retrospective studies and personal experience, with one multicentre study. No randomized controlled studies exist regarding the management of PAA. CONCLUSIONS: 1. Although most PAA are of atherosclerotic origin in old patients, trauma, infection and family history are the main causes in young patients. 2. Great vigilance is needed for diagnosis as only approximately five patients are seen each year by a major vascular centre. There is no place for screening programmes to detect PAA. 3. Approximately 45% of patients are asymptomatic at the time of initial diagnosis. Aortic aneurysms are found in 40% and bilateral PAA in 50% of patients. More than 95% of patients are men with a mean age of 65 years and 45% have hypertension. 4. Surgical reconstruction is recommended for all symptomatic and asymptomatic aneurysms larger than 2 cm. Five-year graft patency rates after surgical repair range from 30 to 97%, with 5-year limb salvage ranging from 70 to 98%. Patient survival rates at 5 and 10 years are 75 and 46%, respectively. 5. If carried out carefully, intra-arterial thrombolysis can safely prepare patients presenting with acute ischaemia from occluded PAA, for surgical revascularization to restore distal run-off. 6. Endovascular repair of a PAA is a feasible option, although little evidence is yet available. 7. Lifelong, careful patient surveillance is essential to detect and treat new aneurysms at other sites.

Aneurysm↗
PubMed1978

Popliteal vein thrombosis secondary to popliteal artery aneurysm.

Two patients with popliteal vein thrombosis secondary to popliteal artery aneurysm are described. The association of venous abnormalities in 623 reported cases of popliteal artery aneurysm is reviewed. The high morbidity from popliteal vein thrombosis would seem to justify preoperative leg venography in patients with popliteal artery aneurysm.

Aneurysm↗
PubMed1992

[The entrapment syndrome of the popliteal artery: diagnosis, therapy, results].

The popliteal artery entrapment syndrome is caused by an anatomical anomaly in the popliteal fossa. Mostly the popliteal artery is compressed by a faulty insertion of the medial head of the gastrocnemius muscle. The main symptom is an intermittent claudication at an early age. We review our experience with four typical cases. All patients were examined because of a unilateral sudden claudication in the calf at ages between 23 and 43 years. In two patients we could find angiographically a typical stenosis, in two others a complete occlusion of the popliteal artery. Additionally a female patient showed a 6 x 8 cm poststenotic aneurysm in the popliteal fossa. Therapeutically we restored the flow of the artery on two patients by dividing the compressing gastrocnemius muscle. As a late complication two years after the first operation one of these patients had an occlusion of popliteal artery which was bypassed by a popliteo-crural vein graft. On two patients we primary inserted a vein graft. All patients were checked 6 months till 5 years after the first operation by duplex scanning, by measurement of pressure at the ankle and by pulse volume recording at the big toe. All our postoperative examinations demonstrate patency of the repairs and the patients have very few problems.

Adult↗
PubMed1995

Colour duplex ultrasonographic imaging and provocation of popliteal artery compression.

OBJECTIVES: Provoked compression of the popliteal artery by active plantar flexion of the foot is still mainstay in the assessment of the popliteal artery entrapment syndrome. In this study, the effects of several provocation manoeuvres of the foot on the flow patterns of the popliteal arteries of normal healthy volunteers were evaluated. DESIGN: Experimental study among healthy volunteers in a vascular laboratory. MATERIALS AND METHODS: The popliteal artery of 16 healthy volunteers was studied with Duplex scanning in rest and during active and passive plantar and dorsal flexion of the foot. RESULTS: Active plantar flexion was the only movement that influenced popliteal artery flow patterns. Changes were found in 27 arteries (85%), consisting of either a complete occlusion (n = 19, 59%), a significant lumen reduction (n = 4, 13%) or a low flow state (n = 4, 13%). CONCLUSION: Compression of the popliteal artery by active plantar flexion of the foot is a physiologic phenomenon and its value in the assessment of patients suspected of the popliteal artery entrapment syndrome is limited.

Adult↗
PubMed1986

[Popliteal artery entrapment syndrome].

Trapped popliteal artery syndrome is relatively uncommon: the literature reports some 60 cases. The clinical picture is linked to compression of the popliteal artery by the gastrocnemius as it contracts, thus distorting the arterial route. The result is an interruption in the blood flow distally to the area involved due to stenosis of the blood vessel that is at first functional but becomes organic.

Adult↗