Roche-Nagle Graham, Wong K T, Oreopoulos George
Department of Vascular and Endovascular Surgery, Toronto General Hospital, Toronto, ON, Canada.
Hong Kong Med J. 2009 Oct;15(5):388-90.
Popliteal artery entrapment syndrome is an important, albeit infrequent, cause of severe disability among young adults and athletes with anomalous anatomic relationships of the musculotendinous structures surrounding the popliteal artery. We report a case where duplex ultrasonography and dynamic magnetic resonance arteriography was used to diagnose popliteal artery entrapment. We used a posterior surgical approach to give the best view of the anatomic structures compressing the popliteal artery. Compression had not yet damaged the arterial wall, therefore operative decompression of the artery by resection of the aberrant muscle was sufficient. The result was complete recovery, with absence of symptoms and with patency verified by Doppler examination. We conclude that emergency physicians who encounter young patients with progressive lower limb arterial insufficiency should be aware of the possibility of popliteal artery entrapment. Early diagnosis using physical examination, history taking, and imaging is necessary. The treatment of choice is surgical correction to achieve normal anatomy within the popliteal fossa.
腘动脉受压综合征是导致年轻成年人和运动员严重残疾的一个重要原因，尽管并不常见，其发生与腘动脉周围肌肉肌腱结构的解剖关系异常有关。我们报告一例通过双功超声和动态磁共振血管造影诊断腘动脉受压综合征的病例。我们采用后入路手术，以便最佳地观察压迫腘动脉的解剖结构。压迫尚未损伤动脉壁，因此通过切除异常肌肉对动脉进行手术减压就足够了。结果是完全康复，无症状，多普勒检查证实血管通畅。我们得出结论，遇到年轻的进行性下肢动脉供血不足患者的急诊医生应意识到腘动脉受压的可能性。通过体格检查、病史采集和影像学进行早期诊断是必要的。首选的治疗方法是手术矫正，以实现腘窝内的正常解剖结构。
