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Results for “POPLITEAL ARTERY”

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PubMedDate not supplied

[Limb pain due to congenital trapping of the popliteal artery].

Two patients with popliteal artery entrapment including one bilateral were operated on in the Cardiovascular and Thoracic Surgery Unit at the UCL between January 1987 and February 1988. Both patients complained of severe intermittent claudication. One of the entrapments resulted from internal deviation of the vessel. The two others were secondary to excessively external insertion of the medial head of the gastrocnemius muscle. These preoperative findings correlated with preoperative CT scan. A section of the medial head of the gastrocnemius resulted in complete liberation of the popliteal artery in each case. In addition, a popliteal thromboendarterectomy was performed in one patient and a lumbar sympathectomy in the other.

Adult↗

PubMed1988

Percutaneous transluminal angioplasty of the superficial femoral artery by retrograde catheterization via the popliteal artery.

We report the results of 50 angioplasty procedures via the popliteal artery. A 3-year follow-up including control of blood pressures at ankle and toe levels show results comparable to reports in the literature. This new approach for angioplasty of the superficial femoral artery and eventually of coexisting iliac lesions enables treatment of previously inaccessible lesions. The technique is especially suited for lesions close to the takeoff of the superficial femoral artery.

Aged↗

PubMed1993

[How often does an aneurysm of the popliteal artery rupture?].

Rupture of a popliteal artery aneurysm is an unusual complication and did occur six times in our series of 252 popliteal artery aneurysms that underwent operative repair from January 1965 to December 1991. Rupture while equally serious as thrombosis of the popliteal artery aneurysm of distal embolization from the aneurysm, is reported as an exceedingly unusual complication. Reported incidence of rupture is less than 2 to 4 percent in most large series and was 2.4 percent in the present series.

Aged↗

PubMed1997

Delayed presentation of popliteal artery pseudoaneurysm following blunt trauma.

Popliteal artery pseudoaneurysms are not uncommon. They may result from penetrating or blunt trauma, arterial reconstructive surgery, invasive diagnostic or surgical orthopedic procedures, and perigenicular neoplasia. We report two patients with popliteal artery pseudoaneurysm diagnosed 3 months and 3 weeks, respectively, after blunt trauma. These two patients as well as many patients reported in the literature had palpable distal pulses and no obvious clinical signs of arterial injury following various forms of trauma. Arteriography in these circumstances is usually abandoned because of the low yield and the possible risk of complications. However, as we illustrate in this report, noninvasive diagnostic modalities such as duplex ultrasound and magnetic resonance arteriography are both safe and accurate for early detection of popliteal artery pseudoaneurysm. Once diagnosed, standard vascular reconstruction should be performed to prevent potential complications.

Adult↗

PubMed1986

Popliteal artery entrapment: diagnosis by computed tomography.

Popliteal artery entrapment by an anomalous band of the gastrocnemius muscle is uncommon. In cases where popliteal artery occlusion has occurred, the diagnosis is difficult to establish. A case is presented in which computed axial tomography of the popliteal space established the diagnosis of popliteal artery thrombosis caused by entrapment when other diagnostic modalities were inconclusive. Computed axial tomography provides precise anatomic display of the muscle structure of the popliteal fossa and should be an important diagnostic tool in patients suspected to have popliteal artery entrapment.

Adult↗

PubMed2006

[Popliteal artery entrampment: report of one case].

Popliteal artery entrampment is a rare condition, occurring in young subjects, that causes ischemia of the extremity. The anatomical background is the compression or occlussion of the popliteal artery caused by forced plantar or dorsal flexion. We report a 32 year-old sportsman who presented with gangrene of the right first toe and a history of three months of progressive claudication. The Ankle-Brachial index and pulse volume curve registries showed a severe ischemia below the knee. Angiography showed a medial deviation of the popliteal artery associated to stenosis and aneurysm formation. A CT scan of the contralateral artery was normal. The patient was operated using a posterior approach, performing a reverse saphenous vein bypass graft and excising the popliteal artery. The postoperative period was uneventful.

Adult↗

PubMed1992

[Use of an active clinical maneuver for diagnosis of popliteal artery entrapment].

Overall incidence rate of popliteal artery entrapment syndrome is certainly underestimated. The aim of this work was to test and to evaluate the interest of a clinical maneuver of active and repetitive ankle extensions in upright position, for the screening, the diagnosis and the follow-up of patients with popliteal artery entrapment. During a 3 year period, this maneuver was used in 10 patients (16 popliteal artery entrapments) and in 50 age-matched controls. The results of the maneuver were compared to the results of functional vascular investigations. For all the patients the maneuver had to be stopped before 20 movements whereas it could be continued up to 50 movements for all the controls. The maneuver was easy to perform, reliable and constant in its results. The earlier the maneuver was stopped the more critical was the trouble at functional vascular investigations. We believe that this maneuver is of great help for early diagnosis of popliteal artery entrapment, assessment of its severity and follow-up treated patients. It could also help to detect athletes with asymptomatic popliteal entrapment.

Adolescent↗

PubMed1998

Factors predicting the diameter of the popliteal artery in healthy humans.

PURPOSE: To determine the relevance of popliteal dilatations, knowledge of the normal popliteal artery diameter is essential. This study investigates the diameter of the popliteal artery in healthy males and females. METHODS: We measured the diameter of the popliteal artery in 121 healthy volunteers (59 males and 62 females), ages 8 to 81, with echo-tracking B-mode ultrasonography. We analyzed the influence of age, sex, height, weight, body surface area (BSA) and systolic blood pressure with a multiple regression model. RESULTS: The popliteal artery increased steadily in diameter throughout life. From 25 years on, the diameter was larger in males than in females. If corrected for BSA, this difference decreased from 17% to 7%. This study found a correlation between popliteal artery diameter and BSA (r=0.47 and r=0.61, respectively, p < 0.0001). Age, followed by BSA, was the most influencing factor on popliteal diameter in both males and females (r=0.62 and r=0.66, respectively, p < 0.0001). We used age and BSA in creating a model for prediction of popliteal artery diameter. CONCLUSIONS: The diameter of the popliteal artery increases with age, initially during growth, but also in adults. This is related to age, body size and sex, with males having larger arteries than females. It is now possible to predict the normal popliteal arterial diameter, and nomograms are presented for use in the study of aneurysmal arterial disease.

Adolescent↗

PubMed2005

Quantifying dynamic contrast-enhanced MRI of the knee in children with juvenile rheumatoid arthritis using an arterial input function (AIF) extracted from popliteal artery enhancement, and the effect of the choice of the AIF on the kinetic parameters.

Quantification of dynamic contrast-enhanced (DCE) MRI based on pharmacokinetic modeling requires specification of the arterial input function (AIF). A full representation of the plasma concentration data, including the initial rise and decay parts, considering the delay and dispersion of the bolus contrast is important. This work deals with modeling of DCE-MRI data from the knees of children with a history of juvenile rheumatoid arthritis (JRA) by using an AIF extracted from the signal enhancement data from the nearby popliteal artery. Three models for the AIFs were considered: a triexponential (AIF1), a gamma-variate plus a biexponential (AIF2), and a biexponential (AIF3). The pharmacokinetic parameters obtained from the model were Ktrans', kep, and V'p. The results from AIF1 and AIF2 showed no statistically significant difference. However, some statistically significant differences were seen with AIF3, particularly for parameters Ktrans' and V'p in the synovium (SNVM). These results suggest the importance of obtaining an appropriate AIF representation in pharmacokinetic modeling of JRA. Specifically, the initial rising part of the AIF should be incorporated for optimal pharmacokinetic modeling results. The pharmacokinetic parameters (mean+/-SD) derived from AIF1, using the average plasma concentration data, were as follows: SNVM Ktrans'(min-1)=0.52+/-0.34, kep(min-1)=0.71+/-0.39, and V'p=0.33+/-0.16, and for the distal femoral physis (DFP) Ktrans'(min-1)=1.83+/-1.78, kep(min-1)=2.65+/-1.80, and V'p=0.46+/-0.31. The pharmacokinetic parameters in the SNVM may be useful for investigating activity and therapeutic efficacy in studies of JRA. Longitudinal studies are necessary to find or demonstrate the parameter that is more sensitive to disease activity.

Adolescent↗

PubMed2005

Stent placement for severe stenosis in the deep femoral artery with the occluded superficial femoral and popliteal arteries.

In both superficial and deep femoral artery involvement, where angioplasty of the former is not suitable or feasible, angioplasty of the latter seems to be the method of choice and is a less invasive and efficient treatment particularly for limb threatening ischemia, an appropriate obstruction morphology provided. The authors describe a case of a 73-year-old man, with a rest pain of the foot and intermittent cyanosis of the toe, who underwent stent placement with transluminal angioplasty for severe stenosis in the deep femoral artery with the occluded superficial femoral and popliteal artery. The patient's ankle brachial index was remarkably increased from 0.25 to 0.61, and the preoperative symptoms were improved.

Aged↗

PubMedDate not supplied

Diagnostic and pathological considerations in the popliteal artery entrapment syndrome.

Four cases of the popliteal artery entrapment syndrome including two with bilateral lesions are reported. All limbs of these patients showed classical arterial entrapment due to the anomalous course of the popliteal artery in relation to the medial head of the gastrocnemius muscle. All cases were diagnosed preoperatively, and computed tomography demonstrated apparent separation of the popliteal artery and vein at the site of the insertion of the gastrocnemius muscle. All patients complained of gradually progressive intermittent claudication except for one who revealed acute leg ischemia following long periods of driving and Japanese-style sitting. Surgical treatment resulted in complete recovery in all limbs. Pathological characteristics in the popliteal artery were: (1) the presence of longitudinal smooth muscle bundles in the medial coat adjacent to the gastrocnemius muscle, and (2) intimal thickening and/or thrombus formation adjacent to the medial condyle of the femur.

Adolescent↗

PubMed2004

Popliteal artery entrapment associated with cannabis arteritis.

OBJECTIVE: To report popliteal artery entrapment in a patient with distal necrosis and cannabis-related arteritis, two rare or exceptional disorders never described in association. To conduct a targeted review and especially to seek information on the clinical presentation with characteristics specific to each disorder so as to hasten the diagnosis and choose appropriate management. MATERIAL AND METHODS: A 19-year-old man who presented with plantar claudication associated with necrosis in a toe underwent diagnostic arteriography and surgery for popliteal artery entrapment type III. RESULTS: Surgical clearance resolved the popliteal artery entrapment but left the clinical symptoms unchanged. Closer questioning disclosed a history of cannabis consumption and intravenous vasodilatory therapy was started. After the 21-day course of vasodilator agents the pain disappeared and the toe necrosis regressed. The patient stopped taking cannabis and had no signs of recurrence. CONCLUSION: Whereas a popliteal artery entrapment, albeit a rare event, is well described and responds to standardized treatment, popliteal artery entrapment associated with cannabis-induced arteritis is an exceptional event that could confuse management. Because young people-the age group mainly at risk for popliteal artery entrapment-increasingly use cannabis, cannabis arteritis could become a more frequent event associated with other arterial disorders that may confuse the diagnosis and complicate management. Our experience in a young patient suggests that coexisting popliteal artery entrapment and distal necrosis in a young patient should raise a strong suspicion of an associated vascular disorder possibly related to cannabis consumption. Intravenous vasodilatation treatment is successful provided that cannabis use is discontinued.

Adult↗

PubMed1998

Cocaine-induced thrombosis of common iliac and popliteal arteries.

Cocaine-induced thrombosis has been reported in the literature; however, its mechanism is not fully understood. Most cases are of small caliber vessels, such as the coronaries and cerebral vasculature. We report a case of a 36-year-old man with signs and symptoms of acute arterial insufficiency in his right lower extremity. At angiography, the right common iliac artery and the popliteal artery were occluded. The patient was successfully treated with thrombolytic therapy. Cocaine-induced thrombosis should be suspected in a patient with history of cocaine abuse who presents with acute arterial insufficiency in an extremity, without an identifiable source.

Acute Disease↗

PubMed2000

Successful percutaneous endovascular treatment of a ruptured popliteal artery aneurysm.

A rupture of the popliteal artery is a rare but dangerous complication of aneurysmal disease. It accounts for 4% of all popliteal artery aneurysms encountered and threatens the loss of the extremity and, infrequently, is also life-threatening.(1) when this clinical entity is confronted, a prompt operative intervention is indispensable for increasing the chances of limb salvage. We report the first, to our knowledge, successful endovascular treatment of a ruptured popliteal artery aneurysm with a new polytetrafluoroethylene stent-graft in a patient who was unfit for a conventional surgical approach because of his severe pulmonary disease.

Alloys↗

PubMedDate not supplied

Morphometric analysis of the popliteal artery for endovascular treatment.

This study intended to determine the precise diameter of the popliteal artery in patients at risk for popliteal aneurysms. Accurate sizing is necessary to develop devices for endovascular treatment of popliteal aneurysms. Fifty-four patients with abdominal aortic aneurysms (AAAs) had computed tomography (CT) scans of the popliteal arteries. Age- and gender-matched control subjects were measured by ultrasound. NIH Image was used to measure the minor diameter at the adductor hiatus (proximal) and femoral condyles (midpopliteal artery). There were 4 unsuspected popliteal aneurysms (7.4%). The proximal popliteal artery was ectatic in these patients: 13.4 +/- 5.2 mm. Proximal and midpopliteal arteries were significantly larger in the other patients with AAAs compared with controls: 9.6 +/- 1.8 mm vs 7.9 +/- 1.1 mm at the hiatus (p<0.001) and 10.2 +/- 2 mm vs 7.9 +/- 0.9 mm at the condyles (p<0.001). The popliteal artery was focally larger in patients with AAAs without popliteal aneurysms. The popliteal artery was larger in men compared with women; 9.8 +/- 1.8 mm vs 8.8 +/- 1.9 mm at the hiatus (p=0.024) and 10.5 +/- 1.9 mm vs 9.0 +/- 2.4 mm at the condyles (p=0.005). The proximal popliteal artery was 2 mm larger in patients at risk for popliteal aneurysms and 5 mm larger in patients with popliteal aneurysms compared to controls. Focal ectasia of the midpopliteal artery was common. Planning for endovascular treatment of popliteal aneurysms must incorporate this striking enlargement.

Aged↗

PubMed1980

Popliteal artery entrapment syndrome. Clinical, noninvasive and angiographic diagnosis.

The popliteal artery entrapment syndrome is increasingly recognized as a cause of arterial insufficiency in the leg. Diagnosis is based on a clinical history of claudication, which may be atypical, physical examination, noninvasive exercise testing and angiography. Patients with normal ankle pulses and resting ankle/brachial pressure indexes may require extensive exercise testing to document arterial insufficiency. Angiographic demonstration of medial deviation of the popliteal artery is diagnostic of the popliteal artery entrapment syndrome. Arteries that appear normal on routine angiography require biplane angiography with various provocative maneuvers to demonstrate induced arterial stenosis. Using this approach, three additional cases of popliteal artery entrapment syndrome were diagnosed preoperatively and successfully treated with surgery.

Adult↗

PubMed1977

3. Current approaches to popliteal artery repair.

Trauma to the popliteal artery is potentially dangerous, and limb loss may result, especially with delayed diagnosis. Three anatomic factors contribute to the seriousness of the outcome: proximity of the artery to bone, superficial position of the artery and consequent lack of protection, and frequent associated injury to associated collateral blood vessels. Diagnosis of injury to the popliteal artery rests on suspicion and vigilance; the Doppler transcutaneous flow detector and angiography are often useful aids to diagnosis. Methods of treatment that have been used include arterial repair, grafting and fasciotomy, together with management of associated injuries. The bypass principle of vascular reconstruction may improve overall results.

Adult↗

PubMed1997

Blunt popliteal artery trauma: a challenging injury.

Blunt popliteal artery trauma is a challenging injury, particularly when associated with major soft tissue damage. We reviewed our experience with this injury to determine 1) the incidence of vascular injury associated with fractures and/or dislocations about the knee, 2) the incidence of limb loss, and 3) factors associated with amputation. We treated 37 patients with 38 blunt popliteal artery injuries and either fractures about the knee or posterior knee dislocations. Patients who underwent primary amputations were excluded. The incidence of popliteal artery injuries with fractures about the knee was 3 per cent, whereas 16 per cent of patients with posterior knee dislocations had vascular injuries (P < 0.05). Amputations were required in 14 of the 38 injured limbs (36%). None of these patients had a pulse or Doppler signal on admission, and 13 had major soft tissue injury. No patient with a pulse or Doppler signal lost a limb (P < 0.05). Limb loss was primarily related to limited venous outflow and/or severe infection in damaged tissue. Failure of the arterial repair rarely led to amputation, particularly in recent years. Two patients with angiographically proven arterial injuries were treated nonoperatively without complications. The incidence of vascular injuries associated with fractures about the knee is low, but somewhat higher with posterior knee dislocations. The overall 9 per cent rate of positive angiograms suggests that a selective approach may be indicated. The amputation rate remains high, but it has improved with an integrated, multidisciplinary team approach. In patients without a pulse or Doppler signal and with severe soft tissue injuries, primary amputation may be appropriate.

Adolescent↗