Document Detail

Occult popliteal artery stenosis masquerading as atheroemboli in a patient with previous knee replacement.
MedLine Citation:
PMID:  16331668     Owner:  NLM     Status:  MEDLINE    
The purpose of this article is to report the unusual presentation of a 63-year-old patient with Rutherford grade 2, category 5 tissue ischemic changes involving the right foot secondary to an occult popliteal stenosis that was obscured behind a prosthetic knee on diagnostic angiograms. Conventional abdominal angiography with bilateral lower extremity runoff showed no evidence of significant disease and the patient was misdiagnosed with atheroemboli syndrome secondary to ipsilateral common femoral access following recent catheterization. Ultimately, a meticulous physical examination disclosed a bruit in the right popliteal fossa and selective right leg angiography with oblique views confirmed eccentric complex luminal encroachment in the right popliteal artery that was eclipsed by a prosthetic knee on antecedent nonselective angiography. The lesion responded favorably to endovascular treatment with durable clinical improvement. This case illustrates the importance of a meticulous physical examination and noninvasive studies prior to angiography in patients with ischemic tissue changes and emphasizes the importance of oblique views to image any vessel that may be obscured by a metal prosthesis.
Mark C Bates; Bradley H Crotty
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  67     ISSN:  1522-1946     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2006 Jan 
Date Detail:
Created Date:  2005-12-27     Completed Date:  2006-07-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  151-4     Citation Subset:  IM    
Cardiovascular Research, Camcare Health Education and Research Institute, Charleston, West Virginia, USA.
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MeSH Terms
Arthroplasty, Replacement, Knee
Balloon Dilatation
Constriction, Pathologic
Embolism, Cholesterol / diagnosis*
Ischemia / diagnosis*,  therapy
Knee Prosthesis*
Leg / blood supply*
Middle Aged
Popliteal Artery / pathology*,  radiography
Radiography, Interventional
Comment In:
Catheter Cardiovasc Interv. 2006 Jan;67(1):155-7   [PMID:  16331667 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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