IS Case 321: Popliteal artery thrombosis

Jerry Lee, MD

Imaging Sciences URMC 2009
Publication Date: 2009-09-14


Patient is a 90-year-old male with acute right lower leg claudication.


Angiogram of the right lower extremity demonstrates an abrupt cutoff of the superior aspect of the right popliteal artery. There are multiple collateral vessels visualized with may indicated more chronic occlusive disease. Vascular ultrasound demonstrates thrombus within the occluded popliteal artery segment.


Popliteal artery occlusive disease is a common occurrence especially in elderly patients, smokers, and those with diabetes mellitus and other cardiovascular disease. Atherosclerosis is by far the most common cause of popliteal artery occlusive disease. Popliteal artery aneurysms are the most common peripheral aneurysms which can be bilateral and are prone to thrombosis. Embolic source such as from atrial fibrillation or myocardial infarction commonly occludes in the popliteal artery. Popliteal entrapment syndrome is a rare cause of popliteal artery occlusive disease and is characterized by an abnormal anatomic relationship of the popliteal artery to the gastrocnemius muscle which causes compression and occlusion. Cystic adventitial disease is rare which forms multiple loculated cysts in the adventitia usually due to prior trauma which can compress the popliteal artery causing thrombus or direct impingement. Trauma is also another cause for occlusive disease such as from direct injury leading to thrombus or dissection.


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