Marlin W. Causey, Thomas Curry, Reagan Quan, Charles Andersen, Niten Singh
Madigan Army Medical Center, Ft. Lewis, WA.
BACKGROUND: Popliteal Entrapment Syndrome is a rare cause of claudication in the young population. These patients are typically referred to multiple specialists prior to their diagnosis and optimal treatment. Ultrasound has commonly been used as an adjunct to clinical diagnosis in most outpatient clinics. We describe additional techniques of using intravascular ultrasound for diagnosis when angiography is performed. More importantly, this video highlights the intraoperative use of ultrasound to ensure an adequate and optimal myectomy when treating popliteal entrapment syndrome as well as an ability to survey the arterial wall for intimal injury with B mode duplex.
TECHNICAL DESCRIPTION: Patients are most commonly diagnosed clinically with popliteal entrapment syndrome. During the time of angiography, intravascular ultrasound is able to demonstrated distinct compression of the popliteal artery with active plantar flexion. Palpation has traditionally been used to assess the adequacy of resection for popliteal entrapment but this may prove to be inadequate with some patients and intraoperative ultrasound allows assessment of the adequacy of resection. We also perform B mode duplex after complete resection to survey for intimal changes that may not have been seen during the preoperative workup.
AUTHOR DISCLOSURES: C. Andersen, Nothing to disclose; M. W. Causey, Nothing to disclose; T. Curry, Nothing to disclose; R. Quan, Nothing to disclose; N. Singh, Nothing to disclose.
Posted April 2012