Document Detail


Popliteal vein entrapment presenting as deep venous thrombosis and chronic venous insufficiency.
MedLine Citation:
PMID:  8230561     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: This report describes popliteal vein entrapment in three patients and demonstrates that it may present with manifestations of typical venous disease.
METHODS: This report was compiled from a review of inpatient and outpatient records.
RESULTS: In the first case, a 28-year-old woman was seen with left leg popliteal and calf deep vein thrombosis without obvious cause. She described long-standing calf discomfort, and passive dorsiflexion of the left foot caused disappearance of arterial pulsations at the pedal level. She was given the anticoagulants heparin and sodium warfarin (Coumadin) followed by surgical exploration. The popliteal vein and artery were entrapped by a fibrous extension of the medial head of the gastrocnemius muscle attaching to the lateral femoral condyle. After band lysis, the patient has been symptom free for 6 years. The second patient, a 37-year-old man, was seen with bilateral chronic venous insufficiency (CVI). Passive dorsiflexion and active plantar flexion of the feet did not diminish the pedal pulses; impedance plethysmography suggested mild outflow obstruction. Ascending venography demonstrated entrapment at the midportion of duplicated popliteal veins with no postthrombotic changes. He was treated with compression stockings and has done well during an 18-month follow-up. The third patient, a 17-year-old male, was seen with severe symptoms of right leg CVI and venous obstruction since 3 years of age. Air plethysmography revealed ambulatory venous hypertension, whereas venography demonstrated reflux down to the knee with an extrinsic narrowing at the midpopliteal vein. During operation, an abnormal origin of the lesser saphenous vein (LSV) from the popliteal vein was found; the LSV took a medial route, compressed the tibial nerve, and caused severe distortion and narrowing of the popliteal vein. Division of the LSV resulted in release of popliteal venous compression and immediate relief of symptoms.
CONCLUSIONS: The three cases presented demonstrate that popliteal venous entrapment may begin with symptoms of deep vein thrombosis and CVI. Popliteal venous entrapment must be considered in the differential diagnosis of venous disease in younger patients in whom common predisposing factors are absent.
Authors:
T M Gerkin; H G Beebe; D M Williams; J R Bloom; T W Wakefield
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of vascular surgery     Volume:  18     ISSN:  0741-5214     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  1993 Nov 
Date Detail:
Created Date:  1993-12-14     Completed Date:  1993-12-14     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  760-6     Citation Subset:  IM    
Affiliation:
Department of Surgery, University of Michigan Medical Center, Ann Arbor 48109-0329.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Constriction, Pathologic
Diagnosis, Differential
Female
Humans
Male
Peripheral Vascular Diseases / complications,  diagnosis
Phlebography
Plethysmography
Popliteal Vein*
Thrombophlebitis / diagnosis,  drug therapy*
Venous Insufficiency / diagnosis,  etiology*

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