PMC7520692_01
Computed tomography angiography demonstrating a coronal view of the behind knee popliteal arteries, with labelled total occlusion of the right popliteal artery and tight stenosis of the left popliteal artery.
CRIVAM2020-2403280.001.jpg
PMC7520692_01_CRIVAM2020-2403280.001.jpg
fig1
To quantify her disease further, computed tomography angiography (CTA) was conducted confirming in-fact bilateral short-segment popliteal artery disease, with a total occlusion on the right, a high-grade stenosis on the left, and three vessel run-offs bilaterally (Figure 1).
Magnetic resonance imaging demonstrating an axial view of bilateral knees. Note the lateral travel of the medial head of gastrocnemius, resulting in a right popliteal artery occlusion and left popliteal artery high-grade stenosis.
CRIVAM2020-2403280.002.jpg
PMC7520692_01_CRIVAM2020-2403280.002.jpg
fig2
Magnetic resonance (MR) angiography was then performed, demonstrating an abnormal medial deviation of bilateral popliteal arteries secondary to an unusually lateral insertion of the medial heads of the gastrocnemius at the superior aspect of the intercondylar notches (Figure 2).
Intraoperative posterior approach of the right popliteal fossa, demonstrating the culprit fibrous muscular band of the medial head of the gastrocnemius.
CRIVAM2020-2403280.003.jpg
PMC7520692_01_CRIVAM2020-2403280.003.jpg
fig3
The popliteal artery was dissected free, noting a tough muscular band of the medial head of the gastrocnemius travelling laterally over the popliteal artery causing extrinsic compression (Figure 3).