Popliteal artery entrapment syndrome: arteriographic findings and thrombolytic therapy.
OBJECTIVE
To review the arteriographic appearance of popliteal artery entrapment syndrome (PAES) and functional popliteal artery entrapment, and determine the role of thrombolysis in the treatment of these disorders.


METHODS
Retrospective review of hospital records from 1991 to 1998.


RESULTS
Seven patients with PAES and one with functional entrapment were identified. The popliteal artery was occluded in two limbs and compressed in 13. Active plantar flexion was necessary to demonstrate impingement in nine limbs. Medial deviation of the popliteal artery was evident in six of 14 patent popliteal arteries, and lateral deviation was observed in one limb. "Classic" abrupt medial angulation of the popliteal artery was observed in one limb. Both limbs were involved in all six patients who underwent bilateral popliteal exploration. Thrombolytic therapy was performed in three limbs. In two instances, it permitted a less extensive surgical procedure than would otherwise have been required.


CONCLUSIONS
There is considerable variability in the arteriographic appearance of PAES, which is arteriographically indistinguishable from functional entrapment. It is frequently bilateral. Thrombolytic therapy does not obviate surgery but may permit a less extensive procedure to be performed.
Department of Radiology, National Naval Medical Center, Bethesda, MD 20889-5600, USA.
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D000328:Adult; D000792:Angiography; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000601:surgery; D003131:Combined Modality Therapy; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000601:surgery; D006801:Humans; D007261:Infusions, Intra-Arterial; D007383:Intermittent Claudication / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000601:surgery; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000601:surgery; D010960:Plasminogen Activators / Q000008:administration & dosage / Q000627:therapeutic use; D011150:Popliteal Artery / Q000000981:diagnostic imaging* / Q000187:drug effects / Q000601:surgery; D012189:Retrospective Studies; D012501:Saphenous Vein / Q000637:transplantation; D017131:Thrombectomy; D015912:Thrombolytic Therapy; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000188:drug therapy; D016909:Tibial Arteries / Q000601:surgery; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage / Q000627:therapeutic use; D014654:Vascular Patency
D010960:Plasminogen Activators; D014568:Urokinase-Type Plasminogen Activator