Popliteal artery entrapment syndrome as a cause of failed treatment of a false popliteal aneurysm

Abstract

Objective Popliteal artery entrapment syndrome is a rare cause of popliteal artery aneurysms. We present a rare case of a false aneurysm associated with popliteal artery entrapment syndrome that was treated with endovascular repair that initially failed. Case report A 60-year-old man with a false popliteal artery aneurysm and limb ischemia was treated with endovascular repair that initially failed. The popliteal artery was suspected to be compressed by an abnormal bundle of muscle according to the findings of a subsequent magnetic resonance imaging examination. The popliteal artery was entrapped by an abnormal slip of the medial gastrocnemius muscle head. Parts of the popliteus muscle were also involved in compression of the popliteal artery, which was not distinguished on preoperative magnetic resonance imaging. Thus, the patient was diagnosed with a mixed type of popliteal artery entrapment syndrome (types III and IV). Bypass with the small saphenous vein was then performed. The patient was finally discharged with satisfactory relief of his ischemic symptoms. Conclusion Popliteal artery entrapment syndrome should be considered before treating popliteal artery aneurysms, especially atypical pseudoaneurysms without significant atherosclerosis. Definitive surgical management rather than endoluminal treatment is required unless combined with open decompressive surgery to correct the musculotendinous anatomy.

Case Report: COVID-19 exacerbates acute lower limb ischemia in patients with popliteal artery entrapment syndrome

“…Even so, the imaging manifestations of the soft tissue around the compressed popliteal artery are still difficult to detect (8). Therefore, it is easily misdiagnosed as lower limb arterial thromboangiitis obliterans, lower limb arterial embolism, and other ischemic diseases (5,6). Furthermore, certain factors may lead to the worsening of PAES ischemia.…”

“…If not diagnosed and treated appropriately, it may lead to disability and even serious consequences, such as amputation (4). This disease is easily confused with lower extremity arterial ischemic diseases such as lower extremity arterial thromboangiitis obliterans, lower extremity arterial embolism, and lower extremity atherosclerosis obliterans (5,6). Therefore, clinical diagnosis is difficult and prone to misdiagnosis, which can affect treatment decisions and clinical prognosis.…”

Popliteal Artery Entrapment Syndrome Presented with Popliteal Artery Pseudoaneurysm: A Case Report

“…Nonetheless, the abrupt rupture of a pre-existing post-stenotic dilatation or damaged PA without aneurysmal dilation could potentially lead to the formation of a pseudoaneurysm. Pseudoaneurysm formation is an exceedingly rare complication of PAES, with only a few reported cases to date [ 9 - 11 ]. In a study by Song et al [ 11 ], endovascular treatment with self-expanding stent graft implantation in a patient with PAA and PAES was reported.…”

“…Pseudoaneurysm formation is an exceedingly rare complication of PAES, with only a few reported cases to date [ 9 - 11 ]. In a study by Song et al [ 11 ], endovascular treatment with self-expanding stent graft implantation in a patient with PAA and PAES was reported. A stent graft was used for treatment because PAES was not initially suspected as the cause of PAA.…”