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At least 559 records · Page 31Linked to original sources

Laser thermal angioplasty for the treatment of obstruction of the distal superficial femoral or popliteal arteries.

The success rates and clinical effectiveness of percutaneous laser thermal angioplasty for obstruction of the distal superficial femoral or popliteal arteries were assessed. Laser thermal angioplasty was performed with the first commercially available laser system on 25 atherosclerotic vascular lesions in 20 lower extremities of 18 patients. Fifteen of the lesions were occlusions (average length, 5.6 +/- 3.1 cm), and 10 were high-grade stenoses (average length, 2.6 +/- 1.8 cm). Indication for angioplasty was claudication limiting life-style in 12 extremities and threatened limb loss in eight. All patients were treated with a 1.5- or 2.0-mm metal-capped optical fiber attached to a 14-W argon-ion laser. Balloon angioplasty was performed after laser recanalization in all successful cases. The patients were followed by Doppler ankle/brachial index and clinical evaluation. Laser thermal angioplasty was technically successful (vessel recanalization) in 18 (90%) of 20 of the cases. Fourteen (70%) of 20 extremities were successes by ankle/brachial index follow-up, while 15 (75%) of 20 remained clinically improved after an average follow-up of 7.8 +/- 5.3 months. Laser thermal angioplasty has a technical and clinical success rate that compares favorably with previous reports of balloon angioplasty. With proper patient selection, laser thermal angioplasty can reduce the difficulty of traversing lesions that are amenable to standard balloon angioplasty and increase the number of vascular lesions that can be treated percutaneously but could not be recanalized without the use of laser energy.

Aged↗

Ruptured mycotic aneurysm of the popliteal artery. A case report and review of the literature.

We report a case of a ruptured mycotic popliteal artery aneurysm as a consequence of septic embolization from infective endocarditis. The clinical presentation and radiological findings are presented. The popliteal, tibio-peroneal, and the antero-tibial arteries were reconstructed using an in situ bifurcated saphenous vein graft. Follow-up at 24 months disclosed a patent repair with normal ankle-brachial index.

Aged↗

Mycotic (infected) aneurysm of the popliteal artery and arthritis following Salmonella bacteriemia.

We report a case of a mycotic (infected) aneurysm of the popliteal artery due to Salmonella enteritidis. The clinical presentation may be confused with other more common causes of diffuse swollen leg, causing a delay in the diagnosis and proper therapy. Prompt surgical resection of the infected aneurysm together with medical therapy is required for successful treatment.

Aged↗

[Cystic degeneration of the adventitia of the popliteal artery as a possible sequela of entrapment syndrome].

We report two cases of cystic adventitial degeneration of the popliteal artery in young sportsmen. The pathogenetic role of microtrauma is suggested by the localisation of the adventitial cysts, the clinical symptoms, as well as the immunohistochemical demonstration of foamy macrophages instead of endothelial cells in the wall of the cysts. In one case the cause of the intermittent claudication could be verified by duplex sonography and comparison of the arterial pressure of both legs with a Doppler method only after physical exercise. As expected, an angiodilatation has only a temporary effect. Therefore a surgical resection of the cyst or of the involved arterial segment had be performed.

Adult↗

Limitations of percutaneous transluminal angioplasty and stenting for the treatment of disease of the superficial femoral and popliteal arteries.

The long-term primary patency rates for percutaneous transluminal angioplasty (PTA) and stenting in treatment of disease of the superficial femoral and popliteal arteries have been disappointing. Three-year primary patency rates of approximately 50% have been reported for PTA and first-generation stents. Early results with newer nitinol stents appear promising; however, long-term data are lacking. One- and 2-year primary patency rates of 76% to 97% and 60% to 84%, respectively, have been reported with nitinol stents. An emerging concern with nitinol stents is the frequency of stent fracture (> or = 25%) after interventions for long-segment disease. A recent study has shown that stent fractures are associated with in-stent restenosis and with significantly lower primary patency at 1 year. The therapeutic success of PTA and stenting correlates with the complexity of the underlying disease. The best results are achieved when treating focal stenoses in patients with good distal runoff. Because endovascular interventions are preferred by patients, can be repeated, and preserve the option of bypass surgery, PTA and stenting are increasingly employed for diffuse and complex SFA disease. Clarifying the role of PTA and stenting in the treatment of complex SFA disease will require future studies that stratify results by both lesion anatomy and treatment indication.

Angioplasty, Balloon↗

Preoperative measurement of the intrathrombotic pressure of a thrombosed popliteal artery aneurysm for decision of surgical indication.

To evaluate the risk of rupture of a 77 mm thrombosed popliteal artery aneurysm (PAA) in an 82-year-old woman, the aneurysm was percutaneously punctured and the intrathrombotic pressure (ITP) was measured preoperatively. The percentage of the mean ITP to the mean brachial artery pressure was 80%. The aneurysm was judged to have the risk of rupture, and replacement with a prosthetic graft was performed. The percentages of the mean ITP to the mean radial artery pressure and to the mean femoral artery pressure measured intraoperatively were 83% and 71%, respectively, which approximated to the percentage measured preoperatively. PAA may have the risk of rupture even though thrombosed, and preoperative measurement of the ITP might be useful to decide surgical indication.

Aged, 80 and over↗

Dissecting aneurysm of the femoral and popliteal arteries.

Dissecting aneurysms of peripheral arteries within the extremities are very rare. We report a case of dissection of the superficial femoral and popliteal arteries, in which the preoperative arteriography was diagnostic and surgical treatment was undertaken before the onset of severe ischaemia. It is recommended that the diagnosis of dissecting aneurysm of a major artery should be considered when limb ischaemia occurs in a younger patient.

Adult↗

Bilateral popliteal artery entrapment syndrome. A case report and clinical considerations.

The authors report their experience in the management of a rare case of bilateral popliteal artery entrapment syndrome occurred to their observation. This unusual pathological entity, arising mostly in young subjects and unilaterally, in this case was bilateral and developed in a 51 years old patient. The clinical case is fully documented by multiple Echo-Doppler and arteriographic examinations which clearly demonstrate the peculiar characteristics of the disease. Finally the patient received a two stage surgical treatment with a good global result. The Authors stress the importance of a correct diagnostic approach to this unusual disease to avoid the possibility to misdiagnose it.

Arterial Occlusive Diseases↗

Comparison of two-dimensional time-of-flight dynamic magnetic resonance angiography with digital subtraction angiography in popliteal artery entrapment syndrome.

OBJECTIVE: To assess dynamic magnetic resonance angiography (MRA) as an alternative to catheter angiography in patients with popliteal artery entrapment syndrome (PAES). PATIENTS AND METHODS: Nine patients with surgically proven PAES underwent provocation digital subtraction angiography (DSA) and 2-dimensional time-of-flight dynamic MRA of the popliteal fossae (total of 17 limbs). Eight normal volunteers also underwent dynamic MRA (total of 16 limbs). Two observers blinded to the surgical findings and the results of DSA independently evaluated the 33 limbs of the 17 subjects on the basis of maximum-intensity projection images and transverse MRA source images. The degree of stenosis was graded and compared with that indicated by DSA. RESULTS: Among the 17 limbs of patients with surgically proven PAES, dynamic MRA suggested the correct diagnosis in 13 (76%) by indicating stenosis greater than 50%. Dynamic MRA indicated stenosis of 1% to 50% for 4 (25%) of the 16 normal limbs and no stenosis in the other 12 normal limbs (i.e., no false positive results). CONCLUSION: Catheter angiography is not necessary if dynamic MRA indicates stenosis of greater than 50% in patients with clinical suspicion of PAES, but is recommended if dynamic MRA indicates stenosis of 1% to 50%.

Adolescent↗

Treatment of popliteal artery aneurysms with the Hemobahn stent-graft.

PURPOSE: To report a prospective study to ascertain the results of popliteal aneurysm treatment with a self-expanding stent-graft. METHODS: In a recent 3-year period, 21 patients (18 men; median age 67 years, range 52-82) with 23 popliteal aneurysms were treated with Hemobahn stent-grafts. Follow-up evaluation included duplex scanning, ankle-brachial index (ABI) measurements, and radiographic examination of the knee. Outcome measures were occlusion of the stent-graft and limb loss. RESULTS: Technical success in placing the stent-graft and excluding the aneurysm was 100%. An additional vascular intervention was performed in the same session in 5 (24%) cases. In the other 16 patients, local anesthesia was used in 10 (63%). During a median follow-up of 15 months (range 2-37), 5 (22%) of 23 stent-grafts occluded, resulting in a cumulative patency of 74%. All occlusions occurred within 6 months after the intervention; 2 were successfully recanalized, and none of the 3 patients with persisting occlusion required an amputation. CONCLUSIONS: The results of this study suggest that endovascular stent-graft repair of popliteal artery aneurysms is feasible. Midterm patency rates are lower compared to traditional surgical repair.

Aged↗

[Thrombosis of the left popliteal artery from hypertrophy of the gemellus muscle (author's transl)].

The authors report a case of thrombosis of the left popliteal artery in a man aged 20 years, secondary to repeated minimal trauma from contact with a hypertrophied internal gemellus muscle. A bifurcation abnormality was also present. They review the anatomical variations seen at the end of the femoro-popliteal trunk and define the clinical and angiographic characteristics of popliteal thrombosis due to adjoining muscle hypertrophy.

Adult↗

Mycoplasma pneumoniae induced popliteal artery thrombosis treated with urokinase.

A 5 year old boy with serological and clinical evidence of Mycoplasma pneumoniae infection, which was complicated by popliteal artery thrombosis, is described. Intra-arterial urokinase, in conjunction with medical treatment, resulted in clinical recovery and angiographic resolution of the thrombus. The variety of extrapulmonary complications associated with the M pneumoniae infections continues to broaden. Thrombolytic therapies should be considered when similar clinical circumstances arise.

Child, Preschool↗

[Cystic degeneration of the popliteal artery adventitia].

The author presents the case-history of a typical clinical picture of a rare vascular affection--cystic degeneration of the adventitia of the popliteal artery in a young man. The diagnostic conclusion was reached by means of duplex sonography and angiography of the extremity, the condition was treated by reconstruction surgery. With regard to its long-term effect the author prefers it to some non-surgical procedures which include in particular transluminal angioplasty or sonographically assisted needle aspiration of the cyst.

Adult↗