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문인성,박장상,고용복,안창혁,전병무 대한혈관외과학회 1994 Vascular Specialist International Vol.10 No.1
Popliteal artery entrapment syndrome should be included in differential diagnosis for chronic arterial occlusive disease, in cases of leg claudicators of young people. This syndrome arises due to abnormally medial displaced popliteal artery which is entrapped and/or occluded by medial head of astrocnemius muscle, especially in knee hyperextension posture. Early surgical intervention is recommended to eliminate the risk of organic pathology and thrombosis of popliteal artery secondary to repeated trauma. Recently, the authors experienced a typical case of popliteal artery entrapment syndrome. The patient was 26 year old muscular man whose body weight was 86 Kg. He began to notice tingling on left foot and claudication of left ankle and foot about 1 month ago. Physical examination revealed remarkable findings such as very weak arterial pulse on left foot on supine position and unusual left popliteal artery pulsation in medial side of left popliteal fossa. Radiologic arteriography showed medially displaced left popliteal artery without distal arterial occlusion. Subsequent CT scan showed also abnormally displaced left popliteal artery medially to medial head of gastrocnemius muscle. Intraoperative left femoral table arteriography with hyperextension of left knee and flexion of left ankle showed segmental occlusion of left popliteal artery. Surgical exploration was carried out by medial approach of left leg under general anesthesia. Left popliteal vein and nerve were found normally positioned in popliteal fossa but the popliteal artery was medially displaced and entrapped in heavy muscle bundle of medial head of gastrocnemius muscle. Surgical procedures included complete severance of medial head to make popliteal artery free from neighbor muscular compression and placement of popliteal artery in normal position near the popliteal vein. Completion table angiography with knee hyperextension confirmed well patent left popliteal artery without any surrounding compression. The postoperative course was very smooth. Now, postoperative 2 months, the patient is doing well with absence of preoperative complaints. This is the first documented report of popliteal artery entrapment syndrome in Korea.
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