PMC9975419_01
Three-dimensional computed tomography angiography of the lower limb. . (A) Frontal view. Approximately 70 mm long severe stenotic lesion (white arrow) was detected in the right popliteal artery. No other specific stenosis was found. (B) Left anterior oblique view. The lesion (white arrowhead) was specifically localized in the right popliteal artery and looked like hourglass.
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FIG1
Cross-section of the computed tomography around the knee joint.. In the continuous left panels, stenotic lesion (white arrow) was detected in the right popliteal artery; on the other hand, in the right panels, there were no stenotic lesions in the left popliteal artery. The white dotted arrows indicate the direction from proximal to distal.
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FIG2
A cross-sectional CT image also showed a severe stenotic lesion in the right popliteal artery (Figure 2).
Images on the right lower limb obtained by catheter angiography and intravascular ultrasound images.. (A) Catheter angiography of the right lower limb. This image was made by merging several images into one. Stenotic lesion was angiographically reduced in the middle segment of the right popliteal artery. (B-F) Intravascular ultrasound cross-sectional images obtained from a 20 MHz device from proximal to distal popliteal artery. (B) Proximal popliteal artery shows typical three-layer appearance of arterial wall. (C), (E) Eccentric compression of the arterial lumen by a crescent-shaped cyst (asterisk). (D) Cysts (dagger) surround lumen circumferentially like a petal. (F) Distal popliteal artery shows typical three-layer appearance of arterial wall.
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FIG3
However, contrary to our expectations, catheter angiography revealed only a minor stenotic lesion in the right popliteal artery (Figure 3A). IVUS showed little in terms of atherosclerosis or thrombus but revealed cystic lesions in the arterial wall of the right popliteal artery (Figure 3B-3F).
Duplex ultrasound of right popliteal artery.. Echo-free space (asterisk) was found in the right popliteal artery (dagger). The left panel is the B mode image, and right panel is the color flow Doppler image.
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FIG4
Duplex ultrasound showed that the true lumen was compressed by echo-free spaces (Figure 4).
Magnetic resonance images of the right popliteal artery. . These cystic lesions (white arrowhead) exhibited low signal intensity on T1-weighted image (left panel) and high signal intensity on T2-weighted image (right panel).
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FIG5