scholarly journals A Very Rare Cause of Lower Limb Ischemia in Young People: Popliteal Artery Entrapment

2018 ◽  
Vol 12 (1) ◽  
pp. 18-28 ◽  
Author(s):  
Hasan Baki Altinsoy ◽  
Ozkan Alatas ◽  
Emjed Khalil ◽  
Kenan Abdurrahman Kara ◽  
Candan Cudi Okten ◽  
...  
Keyword(s):  
Young People ◽  
Early Diagnosis ◽  
Popliteal Artery ◽  
Lower Limb ◽  
Limb Ischemia ◽  
Diagnostic Tools ◽  
Type I ◽  
Conventional Angiography ◽  
Lower Limb Ischemia ◽  
Popliteal Artery Entrapment

Background: Popliteal artery entrapment syndrome (PAES) is a very rare pathology that can cause lower extremity ischemia in healthy young people. Anomalous anatomic relationships between the popliteal artery (PA) and the surrounding musculo-tendinous structures cause PAES. We present 31 patients with PAES in 35 limbs that were treated surgically in our clinic within a 12-year period. Patients and Methods: From 2001 to 2015, 31 patients (mean age: 32 ± 7.4 years) underwent surgery for PAES. ; 4 patients presented had bilateral PAES. Doppler ultrasonography (US), magnetic resonance angiography (MRA), and conventional angiography were performed as diagnostic procedures. We detected Type I PAES in 4 limbs and Type II PAES in 12 limbs. In the remaining 19 limbs, we diagnosed Type III or Type IV PAES. Simple release of the PA, PA embolectomy and simple release, and the radial artery (RA) patch angioplasty, with or without thromboendarterectomy (TEA), were performed. In 12 limbs, PA continuity was provided by RA interposition. Results: With the exception of 5 patients, no complications were seen after surgery. Haematoma was detected in 2 patients and local infection in 2 patients. One patient required a revision for recurrent PA thromboembolic event 12 h after surgery. At a median follow- up of 23 months (range: 11-29 months), there were no postoperative complications. Conclusions: PAES can result in lower limb ischemia due to chronic vascular trauma in young healthy patients. The use of diagnostic tools such as US, a non-invasive method, and MRA are effective diagnostic tools for early diagnosis. With their combined approach, exact and early diagnosis can be achieved. PA release, alone or with arterial bypass using RA, is a viable treatment option when intervention is necessary to prevent limb loss in the early stages of the disease.

scholarly journals NEXT AND LONG-TERM RESULTS OF X-RAY ENDOVASCULAR INTERVENTIONS IN TREATMENT OF CHRONIC CRITICAL ATHERODIABETIC ISCHEMIA OF LOWER EXTREMITIES

2020 ◽  
Vol 18 (6) ◽  
pp. 710-715
Author(s):  
N. N. Ioskevich ◽  
◽  
L. F. Vasilchuk ◽  
P. E. Vankovich ◽  
S. P. Antonenko ◽  
...  
Keyword(s):  
Lower Limb ◽  
Type I Diabetes ◽  
Lower Extremities ◽  
Limb Ischemia ◽  
Type I ◽  
Critical Ischemia ◽  
Lower Limb Ischemia ◽  
X Ray ◽  
Endovascular Interventions

Background. The treatment of chronic critical ischemia of the lower extremities with their combined atherodiabetic lesion is one of the far from the resolved problems of modern surgery. Aim of the study. Analysis of the results of X-ray endovascular interventions in patients with critical lower limb ischemia due to atherodiabetic lesions of the femoral-popliteal-tibial segment. Material and methods. We analyzed the results of REVS in 60 patients with diabetes mellitus with critical ischemia of the lower extremities due to infra-anginal atherosclerotic occlusions with a follow-up period of up to 5 years from the moment of the manipulation. Results. The total shelf life of the lower limb after REVV was 492.4 ± 10.1 days. Out of 26 amputations performed, balloon angioplasty was performed in 18 cases and stenting in 8 cases. In individuals with type I diabetes, the duration of painless period was 415.4 ± 5.1 days, and the total shelf life of the leg was 465.4 ± 4.3 days. In type II diabetes, these indicators were, respectively, 181.4 ± 4.4 days and 317.8 ± 6.7 days. In the group of patients with type I diabetes, the lower limb was saved in 55.6% of cases (in 20 out of 36 patients), and in type II diabetes - in 58.3% (in 14 out of 24 people). Conclusions. The presence of simultaneously obliterating atherosclerosis and diabetes mellitus in patients leads to a combined atherodiabetic lesion of the arterial bed, including infra-anginal arteries. X-ray endovascular interventions (balloon angioplasty and stenting) on the arterial femoral-popliteal-tibial segment are a rather effective method of eliminating chronic critical lower limb ischemia, which allows preserving the lower limb in 56.7% patients with a follow-up period of up to 5 years from the date of surgery. Improving the results of X-ray endovascular interventions in case of chronic critical atherodiabetic lower limb ischemia requires a comprehensive study of the possible causes of occlusions of reconstructed arterial segments (blood coagulation potential, non-optimal processes in the intervention zone).

scholarly journals Lower limb ischemia due to popliteal artery compression by Baker cyst

2018 ◽  
Vol 4 (2) ◽  
pp. 99-101 ◽  
Author(s):  
Kazuhiro Fujiyoshi ◽  
Yoshiyasu Minami ◽  
Taiki Tojo ◽  
Dai Iwase ◽  
Mitsuhiro Hirata ◽  
...  
Keyword(s):  
Popliteal Artery ◽  
Lower Limb ◽  
Limb Ischemia ◽  
Lower Limb Ischemia

In the Absence of Distal Runoff, Open Thromboendarterectomy Can Save the Limb in Patients with Prolonged Lower Limb Ischemia Due to Popliteal Artery Occlusion

2009 ◽  
Vol 23 (6) ◽  
pp. 821
Author(s):  
Majid Moini ◽  
Mohammad R. Rasouli ◽  
Pedram Heidari ◽  
Golsa Sheykholeslami ◽  
Marjan Rasouli
Keyword(s):  
Popliteal Artery ◽  
Lower Limb ◽  
Limb Ischemia ◽  
Artery Occlusion ◽  
Lower Limb Ischemia

scholarly journals Popliteal Artery Entrapment Syndrome (PAES) in a 17-Year-Old Adolescent

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Viktor Labmayr ◽  
Aryan Aliabadi ◽  
Kurt Tiesenhausen ◽  
Marianne Brodmann ◽  
Florian Schmid ◽  
...  
Keyword(s):  
Popliteal Artery ◽  
Femoral Condyle ◽  
Limb Ischemia ◽  
Exercise Intolerance ◽  
Acute Limb Ischemia ◽  
Conventional Angiography ◽  
Entrapment Syndrome ◽  
Popliteal Artery Entrapment Syndrome ◽  
Popliteal Artery Entrapment ◽  
Vascular Compromise

Introduction. Popliteal artery entrapment syndrome (PAES) is caused by compression of the popliteal artery (PA) due to deranged myotendinous structures. It can be asymptomatic or may present with exercise intolerance, claudication, or even limb-threatening ischemia. The clinical picture depends on the anatomy and degree of vascular compromise. Case Description. We report a case of a 17-year-old Caucasian male with PAES Type II presenting with intermittent claudication and progression towards acute limb ischemia. Diagnostics. MRI and MRA helped identifying the aberrant anatomy and thrombotic occlusion. Doppler ultrasound and conventional angiography have also been employed in a stepwise approach. Intervention. The thrombus at the site of occlusion was removed by the use of catheter-directed lysis. Subsequently, popliteal artery release was achieved by myotomy of the aberrant medial head of gastrocnemius muscle (MHGM) and muscle transfer to the medial femoral condyle. A three-month regimen of 60mg edoxaban was recommended after surgery. Outcome. Surgical correction of the anomalous anatomy and postoperative anticoagulation led to freedom of symptoms. Lesson. Clinical presentation of PAES mimicking peripheral artery occlusive disease is very rare but potentially limb-threatening. PAES should be considered in young and otherwise healthy individuals.

scholarly journals COVID-19 Related Acute Lower Limb Ischemia Treated Via Percutaneous Thrombectomy and Catheter Direct Thrombolisis

2021 ◽  
Vol 6 (3) ◽  
pp. 1-7
Author(s):  
Francesco De Santis ◽  
Keyword(s):  
Popliteal Artery ◽  
Lower Limb ◽  
Mechanical Thrombectomy ◽  
Limb Ischemia ◽  
High Rate ◽  
Lower Limb Ischemia ◽  
Percutaneous Mechanical Thrombectomy ◽  
Selective Approach ◽  
Catheter Directed Thrombolysis ◽  
Angio Ct

Background: The aim of this report is to describe and discuss a unique case of acute lower limb ischemia presented in a recovered COVID-19 patient treated via percutaneous mechanical thrombectomy and catheter directed thrombolysis. Starting from this singular case a wide literature review regarding COVID-19-related thrombo-embolic complications has been accomplished. Methods: A 47-year-old male was admitted to the emergency unit with acute lower limb ischemia three weeks after testing positive for COVID-19. He had been isolated at home because of minor COVID-19-related symptoms. Angio-CT-imaging showed a segmental occlusion of the common iliac artery coupled with retro-articular popliteal artery and leg vessels thrombosis. The patient was first unsuccessfully submitted to trans-femoral iliac thrombo-embolectomy. Results: Instead of peripheral limb vessel re-thromboembolectomy, a percutaneous mechanical thrombectomy coupled with leg vessel catheter direct thrombolysis was performed. The completion angiography showed the recanalization of the popliteal artery and leg vessels as far as the ankle but with a reduced forefoot vascularization. The fibrinolytic treatment was continued for 8 hours post-operatively. A compartment syndrome complicated the early post-operative course. There was a progressive recovery of ischemic symptoms and at 6-month follow-up, peripheral pulses were palpable with an almost complete normalization of foot and toe perfusion and motility. Conclusion: Acute lower limb ischemia following COVID-19-related arterial thrombo-embolic events represents a severe complication of COVID-19 infection and may result in a high rate of revascularization failure. In these cases, Percutaneous Mechanical thrombectomy coupled with catheter directed thrombolysis might represent a less traumatic and more selective approach.

scholarly journals Angio-Seal™ Embolization: A Rare Etiology of an Acute Distal Limb Ischemia

2017 ◽  
Vol 2017 ◽  
pp. 1-3 ◽  
Author(s):  
Glenmore Lasam ◽  
Joshua Brad Oaks ◽  
Jeffrey Brensilver
Keyword(s):  
Compartment Syndrome ◽  
Femoral Artery ◽  
Popliteal Artery ◽  
Lower Limb ◽  
Limb Ischemia ◽  
Vascular Complication ◽  
Closure Device ◽  
Lower Limb Ischemia ◽  
Diagnostic Cardiac Catheterization ◽  
The Right

We herein report a serious vascular complication of diagnostic cardiac catheterization due to an embolization of an Angio-Seal closure device causing acute lower limb ischemia. The Angio-Seal was deployed via the right femoral artery following the catheterization which embolized several hours later to the right popliteal artery. Fogarty embolectomy restored perfusion to the right lower limb; however, compartment syndrome subsequently developed which required evacuation of a hematoma and repair of right popliteal artery.

scholarly journals Sciatic vessels – a case report

2021 ◽  
Vol 18 (4) ◽  
pp. 326-327
Author(s):  
Łukasz Gałuszka ◽  
◽  
Natalia Leksa ◽  
Dawid Leksa ◽  
Adam Uryniak ◽  
...  
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Sciatic Nerve ◽  
Popliteal Artery ◽  
Lower Limb ◽  
Good Condition ◽  
Limb Ischemia ◽  
Lower Limb Ischemia

Introduction. Sciatic vessels most often accompany the sciatic nerve. Sciatic vessels are very rare. Aim. In this paper we determine the procedure in sciatic vessels surgical treatment. Description of the case. We present the case of a 75-year-old patient with symptoms of acute right lower limb ischemia. The patient was discharged home in good condition, and remains in outpatient control to this day. Conclusion. The popliteal artery proved to be available, but much deeper than usual.

Cardiac troponin I in patients with acute upper and lower limb ischemia

VASA ◽  
2008 ◽  
Vol 37 (4) ◽  
pp. 327-332 ◽  
Author(s):  
Koutouzis ◽  
Sfyroeras ◽  
Moulakakis ◽  
Kontaras ◽  
Nikolaou ◽  
...  
Keyword(s):  
Upper Limb ◽  
Lower Limb ◽  
Cardiac Troponin ◽  
Cardiac Involvement ◽  
Troponin I ◽  
Limb Ischemia ◽  
Elevated Troponin ◽  
Troponin Elevation ◽  
Lower Limb Ischemia ◽  
Ischemia Group

Background: The aim of this study was to investigate the presence, etiology and clinical significance of elevated troponin I in patients with acute upper or lower limb ischemia. The high sensitivity and specificity of cardiac troponin for the diagnosis of myocardial cell damage suggested a significant role for troponin in the patients investigated for this condition. The initial enthusiasm for the diagnostic potential of troponin was limited by the discovery that elevated cardiac troponin levels are also observed in conditions other than acute myocardial infarction, even conditions without obvious cardiac involvement. Patients and Methods: 71 consecutive patients participated in this study. 31 (44%) of them were men and mean age was 75.4 ± 10.3 years (range 44–92 years). 60 (85%) patients had acute lower limb ischemia and the remaining (11; 15%) had acute upper limb ischemia. Serial creatine kinase (CK), isoenzyme MB (CK-MB) and troponin I measurements were performed in all patients. Results: 33 (46%) patients had elevated peak troponin I (> 0.2 ng/ml) levels, all from the lower limb ischemia group (33/60 vs. 0/11 from the acute upper limb ischemia group; p = 0.04). Patients with lower limb ischemia had higher peak troponin I values than patients with upper limb ischemia (0.97 ± 2.3 [range 0.01–12.1] ng/ml vs. 0.04 ± 0.04 [0.01–0.14] ng/ml respectively; p = 0.003), higher peak CK values (2504 ± 7409 [range 42–45 940] U/ml vs. 340 ± 775 [range 34–2403] U/ml, p = 0.002, respectively, in the two groups) and peak CK-MB values (59.4 ± 84.5 [range 12–480] U/ml vs. 21.2 ± 9.1 [range 12–39] U/ml, respectively, in the two groups; p = 0.04). Peak cardiac troponin I levels were correlated with peak CK and CK-MB values. Conclusions: Patients with lower limb ischemia often have elevated troponin I without a primary cardiac source; this was not observed in patients presenting with acute upper limb ischemia. It is very important for these critically ill patients to focus on the main problem of acute limb ischemia and to attempt to treat the patient rather than the troponin elevation per se. Cardiac troponin elevation should not prevent physicians from providing immediate treatment for limb ischaemia to these patients, espescially when signs, symptoms and electrocardiographic findings preclude acute cardiac involvement.

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