{"title":"Spontaneous non-aneurysmal popliteal artery dissection managed without operative treatment: A case report and literature review.","authors":"Ellen Liekens, Katrien Lauwers, Peter Goverde","doi":"10.1177/17085381231157123","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>Primary arterial dissection in peripheral arteries of the extremities is exceedingly rare. Isolated dissection of peripheral arteries (femoropopliteal or popliteal) primarily has been reported in aneurysmal arteries. Spontaneous dissection limited to a non-aneurysmal popliteal artery was first described in 1999 by Rabkin et al.</p><p><strong>Methods: </strong>We report a case of a non-aneurysmal popliteal artery dissection to emphasize its rare condition.</p><p><strong>Results: </strong>A 61-year-old man consulted because of sudden onset of pain and cramps in his left leg after walking 60 metres. A high-resolution duplex ultrasonography could identify a dissection of a non-aneurysmal popliteal artery. Computed tomography angiography could confirm the diagnosis. An operative repair was scheduled 3 weeks later and the patient was put on antiplatelet medication (acetylsalicylic acid 80 mg 1x/day) in the meantime. After 3 weeks the dissection was resolved spontaneously and the patient didn't undergo surgery. Check-ups remained reassuring and we scheduled a duplex ultrasonography within one year. Antiplatelet medication was continued.</p><p><strong>Conclusions: </strong>Spontaneous dissection limited to a non-aneurysmal popliteal artery is extremely rare. Diagnosis can be made by duplex ultrasonography and/or CT angiography. Treatment options consist of conservative management or operative treatment. Operative treatments consist of an open repair with bypass or interposition graft or minimal invasive endovascular stent grafting. A standardized protocol for conservative treatment in this specific condition is not available. Annual follow-up of these patients is essential.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":null,"pages":null},"PeriodicalIF":1.0000,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Vascular","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/17085381231157123","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/3/20 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"PERIPHERAL VASCULAR DISEASE","Score":null,"Total":0}
引用次数: 0
Abstract
Objectives: Primary arterial dissection in peripheral arteries of the extremities is exceedingly rare. Isolated dissection of peripheral arteries (femoropopliteal or popliteal) primarily has been reported in aneurysmal arteries. Spontaneous dissection limited to a non-aneurysmal popliteal artery was first described in 1999 by Rabkin et al.
Methods: We report a case of a non-aneurysmal popliteal artery dissection to emphasize its rare condition.
Results: A 61-year-old man consulted because of sudden onset of pain and cramps in his left leg after walking 60 metres. A high-resolution duplex ultrasonography could identify a dissection of a non-aneurysmal popliteal artery. Computed tomography angiography could confirm the diagnosis. An operative repair was scheduled 3 weeks later and the patient was put on antiplatelet medication (acetylsalicylic acid 80 mg 1x/day) in the meantime. After 3 weeks the dissection was resolved spontaneously and the patient didn't undergo surgery. Check-ups remained reassuring and we scheduled a duplex ultrasonography within one year. Antiplatelet medication was continued.
Conclusions: Spontaneous dissection limited to a non-aneurysmal popliteal artery is extremely rare. Diagnosis can be made by duplex ultrasonography and/or CT angiography. Treatment options consist of conservative management or operative treatment. Operative treatments consist of an open repair with bypass or interposition graft or minimal invasive endovascular stent grafting. A standardized protocol for conservative treatment in this specific condition is not available. Annual follow-up of these patients is essential.
期刊介绍:
Vascular provides readers with new and unusual up-to-date articles and case reports focusing on vascular and endovascular topics. It is a highly international forum for the discussion and debate of all aspects of this distinct surgical specialty. It also features opinion pieces, literature reviews and controversial issues presented from various points of view.