Popliteal artery entrapment syndrome

Case contributed by Dr Andrew Dixon

Presentation

Sportsman presented with symptoms of acute left leg ischemia on a background of intermittent claudication.

Patient Data

Age: 17 years
Gender: Male

Abnormal anatomic relationship between the medial head of gastrocnemius (MHG) and the popliteal artery. The artery (with absent flow void) is seen to be abnormally displaced medial to the medial head of gastrocnemius and is separated from the popliteal vein.

Left popliteal artery is thrombosed (absent flow void). The abnormal location of the popliteal artery medial to the medial head of gastrocnemius is seen bilaterally, which is often the case.

Case Discussion

MR angiogram images demonstrate a 15 cm segment occlusion of the left popliteal artery. A predisposing anatomical anomaly is seen with the popliteal artery located medial to the medial head of gastrocnemius (MHG) and separate to the popliteal vein.  

Findings are consistent with thrombotic occlusion of the left popliteal artery due to popliteal artery entrapment syndrome.  The occlusion is unilateral however the anatomic anomaly is bilateral, which is often the case.    

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

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