Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content +++ Popliteal Entrapment + • Rare cause of stenosis or occlusion• Occurs because of anomalous course of popliteal artery• Popliteal artery passes medial to medial head of gastrocnemius muscle (normally passes lateral)-Causes compression of popliteal artery when knee extended• 5 anatomic variations• Fibrous thickening progresses to occlusion, with poststenotic dilation which may be source for mural embolus +++ Cystic Degeneration of Popliteal Artery + • Arterial stenosis produced by mucoid cyst in adventitia• Located in middle third of artery +++ Epidemiology +++ Popliteal Entrapment + • Occurs more often in young, healthy persons +++ Symptoms and Signs +++ Popliteal Entrapment + • Symptoms range from calf claudication to severe ischemia• Diminished pedal pulses with foot dorsiflexion and plantar flexion• Atherosclerotic changes absent +++ Cystic Degeneration of Popliteal Artery + • Calf claudication most common• Decreased pedal pulse strength• Mass may be palpated (rarely) +++ Imaging Findings +++ Popliteal Artery Entrapment + • MRI often useful to diagnose +++ Cystic Degeneration of Popliteal Artery + • Arteriography: Sharply localized zone of politeal stenosis with smooth concentric tapering, having hourglass appearance• US/CT scan: Can demonstrate cyst in artery wall + • Atherosclerotic changes absent + • Complete history and physical exam-Consider diagnosis in young healthy patient with calf claudication or ischemia +++ Surgery +++ Popliteal Entrapment + • Division of medial head of gastrocnemius muscle, graft replacement of diseased artery; lumbar sympathectomy performed as well +++ Cystic Degeneration of Popliteal Artery + • Cyst excision, may recur• Arterial excision and graft replacement may be necessary in some patients +++ References ++Ring DH Jr et al. Popliteal artery entrapment syndrome: arteriographic findings and thrombolytic therapy. J Vasc Interv Radiol. 1999:10:713. ++O'Hara N et al. Surgical treatment for popliteal artery entrapment syndrome. Cardiovasc Surg. 2001;9:141. Your Access profile is currently affiliated with [InstitutionA] and is in the process of switching affiliations to [InstitutionB]. Please select how you would like to proceed. Keep the current affiliation with [InstitutionA] and continue with the Access profile sign in process Switch affiliation to [InstitutionB] and continue with the Access profile sign in process Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Error: Incorrect UserName or Password Username Error: Please enter User Name Password Error: Please enter Password Sign in Forgot Password? Forgot Username? Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free profile for additional features.