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Death after closed adolescent knee injury and popliteal artery occlusion: a case report and clinical review.
A healthy adolescent male soccer player sustained a radiograph-negative, effusion-negative physeal injury of the proximal tibia from a ground-level fall with traumatic occlusion of the popliteal artery. Orthopaedic evaluation and arteriography were delayed for 72 hours after the injury. He arrived at a tertiary referral center in multisystem organ failure secondary to lower extremity ischemic necrosis, septic pulmonary thromboembolism, and systemic shock. Emergent medical evaluation, a high index of suspicion, and a careful neurovascular examination are imperative after every closed knee injury in the young athlete
Squatting -An Unusual Cause Of Popliteal Artery Thrombosis
We report a case of acute popliteal artery occlusion in a young male farmer as a result of prolonged squattin
Popliteal artery entrapment associated with cannabis arteritis.
OBJECTIVE: To report popliteal artery entrapment in a patient with distal necrosis and cannabis-related arteritis, two rare or exceptional disorders never described in association. To conduct a targeted review and especially to seek information on the clinical presentation with characteristics specific to each disorder so as to hasten the diagnosis and choose appropriate management. MATERIAL AND METHODS: A 19-year-old man who presented with plantar claudication associated with necrosis in a toe underwent diagnostic arteriography and surgery for popliteal artery entrapment type III. RESULTS: Surgical clearance resolved the popliteal artery entrapment but left the clinical symptoms unchanged. Closer questioning disclosed a history of cannabis consumption and intravenous vasodilatory therapy was started. After the 21-day course of vasodilator agents the pain disappeared and the toe necrosis regressed. The patient stopped taking cannabis and had no signs of recurrence. CONCLUSION: Whereas a popliteal artery entrapment, albeit a rare event, is well described and responds to standardized treatment, popliteal artery entrapment associated with cannabis-induced arteritis is an exceptional event that could confuse management. Because young people-the age group mainly at risk for popliteal artery entrapment-increasingly use cannabis, cannabis arteritis could become a more frequent event associated with other arterial disorders that may confuse the diagnosis and complicate management. Our experience in a young patient suggests that coexisting popliteal artery entrapment and distal necrosis in a young patient should raise a strong suspicion of an associated vascular disorder possibly related to cannabis consumption. Intravenous vasodilatation treatment is successful provided that cannabis use is discontinued
Popliteal artery injury following traumatic knee joint dislocation in a 14-year-old boy: A case report and review of the literature
Introduction. Posterior knee joint dislocation associated with injury of the
popliteal artery in children is an extremely rare condition. Rapid diagnosis
and treatment are essential for limb salvage and function. Case report. We
reported a 14-year-old boy who suffered traumatic displacement of the right
knee and contusion of the popliteal artery during motorcycle accident. The
diagnosis was confirmed using Doppler and duplex ultrasonography and digital
substraction transfemoral arteriography. The urgent surgical procedure was
performed using posterior approach to the popliteal artery. During the
surgical exploration, rupture of the posterior cruciate ligament associated
with thrombosed popliteal artery have been found. The damaged popliteal
artery was resected and replaced with autologous saphenous vein graft. The
last stage of the procedure was a transosseous femoral fixation of posterior
circuate ligament. A 3-year-follow-up after the surgery demonstrated intact
arterial perfusion and very good function of the knee with a minimal
difference as compared with the contralateral knee. Conclusion. Combined
orthopedic and vascular injuries are very rare in children. They require
combined treatment. [Projekat Ministarstva nauke Republike Srbije, br.
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Higher division of popliteal artery: a case report
During the routine dissection of anatomy in an adult male cadaver at the department of anatomy, Manipal University, Manipal, higher division of popliteal artery was observed on the right side. This artery divided proximal to upper border of popliteus muscle into anterior and posterior tibial arteries. Inferomedial genicular artery which is usually a branch of popliteal artery was found to be arising from anterior tibial artery. However arterial branching pattern and point of bifurcation of popliteal artery on the left side were usual. The knowledge of these variations will be useful for angiography or various surgical approaches during knee joint surgery.
Venous occlusion plethysmography vs. Doppler ultrasound in the assessment of leg blood flow kinetics during different intensities of calf exercise
PurposeIt has recently been shown that venous occlusion plethysmography (VOP) can successfully assess the rate of increase in leg blood flow (LBF) (LBF kinetics) responses during calf exercise, but there is lack of data supporting its validity.MethodsUsing Doppler ultrasound (DU) as a criterion standard technique, we tested the hypothesis that VOP would provide similar estimates of LBF kinetics responses as DU during calf plantar-flexion exercise at a range of different intensities. Ten healthy men performed repeated intermittent calf plantar-flexion contractions (3 s duty cycles, 1 s contraction/2 s relaxation) at 30, 50 and 70% maximum voluntary contraction (MVC) on different days.ResultsResting LBF values were significantly (P < 0.05) larger for DU than VOP but the overall mean LBF responses during exercise were not different (P > 0.05) between DU and VOP (30% MVC: 330 ± 78 vs. 313 ± 92 ml/min; 50% MVC: 515 ± 145 vs. 483 ± 164 ml/min; 70% MVC: 733 ± 218 vs. 616 ± 229 ml/min). LBF kinetics analyses revealed that the end-amplitude at the highest intensity (70% MVC) was significantly higher when measured by DU compared with VOP, but all other kinetics parameters were not different between VOP and DU.ConclusionsGiven that these slight differences in amplitude observed during exercise can be explained by differences in vascular regions which the two techniques assess, our results suggest that VOP can accurately assess LBF kinetics responses during calf plantar-flexion exercise at intensities between 30 and 70% MVC
Editor's choice : European Society for Vascular Surgery (ESVS) 2020 clinical practice guidelines on the management of acute limb ischaemia
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Cystic adventitial disease of the popliteal artery (CADPA): a case report
Cystic adventitial disease of the popliteal artery (CADPA) is a rare vascular, non-atherogenic disease. In most cases it occurs in the popliteal artery, between media and adventitia of the arterial wall. A cyst is a one- or multi-compartment structure filled with gelatinous content. By direct compression it leads to the destruction of the arterial wall and by narrowing or closing an artery it causes limb ischaemia resulting in intermittent claudication. This paper reports the case of a 29-year-old male with CADPA of the left popliteal artery, diagnostic process and treatment history
Bilateral Popliteal Entrapment Syndrome in a Young Athlete Diagnosed with Ultrasound
Popliteal artery entrapment syndrome (PAES) occurs when the popliteal artery is compressed by abnormally developed or hypertrophied muscles adjacent to the popliteal fossa. When symptomatic, it most frequently presents with leg cramping while walking or running. We describe the case of an 18-year-old female runner presenting with claudication and exercise intolerance. After MRI was non-diagnostic, diagnostic ultrasound demonstrated that she had functional (Type VI) PAES. She subsequently underwent popliteal artery release surgery. Type VI PAES should be considered in young, healthy patients who present with claudication, particularly athletes
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