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.