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Revista Colombiana de Cirugía
versión impresa ISSN 2011-7582versión On-line ISSN 2619-6107
Resumen
RODRIGUEZ-PADILLA, Javier y CARRASCOSA-MIRON, Teresa. Critical lower extremity ischemia in a young patient: atypical presentation of the popliteal artery entrapment syndrome. rev. colomb. cir. [online]. 2021, vol.36, n.1, pp.161-164. Epub 07-Mayo-2021. ISSN 2011-7582. https://doi.org/10.30944/20117582.554.
Introduction.
The popliteal entrapment syndrome is an infrequent entity, whose incidence ranges between 0.17 and 3.5%, representing one of the main causes of lower limb ischemia in young adults. It usually manifests with intermittent claudication (69%) or acute ischemia (26%), being very rare its presentation with critical ischemia of the lower limbs.
Clinical case.
A 30-year-old patient with a history of smoking, with no other risk factors, who presented with a subungual ulcer on the first right toe. On physical examination, distal pulses are not palpated, intense skin paleness and coldness are observed. Magnetic resonance imaging showed an anomalous insertion of the medial gastrocnemius with extrinsic compression of the popliteal artery, confirming a diagnosis of popliteal entrapment syndrome type I. Vascular reconstruction with venous graft and tendon section of the medial gastrocnemius was performed through a posterior approach. In the immediate postoperative period, the patient recovers a pediatric pulse and in the one-year follow-up the patient does not present symptoms of lower limb ischemia, finding the bypass patent.
Discussion.
Discussion. Despite its low incidence, it is important to include popliteal impingement syndrome in the differential diagnosis of lower limb ischemia in young adults. Its presentation with critical ischemia is exceptional, finding very few cases published in the literature. Early arterial reconstruction by graft or plasty with autologous material is the treatment of choice.
Palabras clave : ischemia; lower extremity; entrapment; popliteal artery; vascular surgical procedures; blood vessel prosthesis.