Bilateral popliteal artery entrapment (dynamic angiogram)

Case contributed by Dr Andrew Dixon

Presentation

Bodybuilder with bilateral leg pain during workouts.

Patient Data

Age: 40 years
Gender: Male

Angiograms demonstrate bilateral popliteal artery entrapment during plantar flexion.  Both popliteal arteries are patent in the neutral position, but are occluded during plantar flexion.  

MRI shows no abnormal relationship between the popliteal artery and the medial head of gastrocnemius (which is usually seen in entrapment) but does demonstrate hypertrophy of the medial gastrocnemius heads which is probably the cause.

Case Discussion

Angiograms demonstrate bilateral popliteal artery entrapment during plantar flexion.  Both popliteal arteries are patent in the neutral position but are occluded during plantar flexion.  

MRI shows no abnormal relationship between the popliteal artery and the medial head of gastrocnemius (which is usually seen in entrapment) but does demonstrate hypertrophy of the medial gastrocnemius heads which is probably the cause.

With thanks to Dr Anthony Kam, Alfred Hospital, Melbourne, Australia.

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