Medical College of Wisconsin
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Occult popliteal artery stenosis masquerading as atheroemboli in a patient with previous knee replacement. Catheter Cardiovasc Interv 2006 Jan;67(1):151-4 PMID: 16331668

Pubmed ID

16331668

Abstract

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.

Author List

Bates MC, Crotty BH

Author

Bradley H. Crotty MD Assistant Professor in the Medicine department at Medical College of Wisconsin




Scopus

2-s2.0-30344433407   1 Citations

MESH terms used to index this publication - Major topics in bold

Arthroplasty, Replacement, Knee
Catheterization
Constriction, Pathologic
Embolism, Cholesterol
Female
Humans
Ischemia
Knee Prosthesis
Leg
Middle Aged
Popliteal Artery
Radiography, Interventional
Stents
jenkins-FCD Prod-300 626508253d14e4184314fb9f66322a03a5906796