Occult popliteal artery stenosis masquerading as atheroemboli in a patient with previous knee replacement. Catheter Cardiovasc Interv 2006 Jan;67(1):151-4
Date
12/07/2005Pubmed ID
16331668DOI
10.1002/ccd.20479Scopus ID
2-s2.0-30344433407 (requires institutional sign-in at Scopus site) 1 CitationAbstract
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 BHAuthor
Bradley H. Crotty MD Associate Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Arthroplasty, Replacement, KneeCatheterization
Constriction, Pathologic
Embolism, Cholesterol
Female
Humans
Ischemia
Knee Prosthesis
Leg
Middle Aged
Popliteal Artery
Radiography, Interventional
Stents
