POPLITEAL VEIN ENTRAPMENT PRESENTING AS DEEP VENOUS THROMBOSIS AND CHRONIC VENOUS INSUFFICIENCY
POPLITEAL VEIN ENTRAPMENT PRESENTING AS DEEP VENOUS THROMBOSIS AND CHRONIC VENOUS INSUFFICIENCY
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DOI：
10.1016/0741-5214(93)90329-k
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发表时间：
1993-11-01
影响因子：
4.3
通讯作者：
WAKEFIELD, TW
中科院分区：
文献类型：
--
作者：
GERKIN, TM;BEEBE, HG;WAKEFIELD, TW
目的：这份报告描述了腘静脉卡压在三个病人，并表明，它可能会出现典型的静脉diseases.Methods的表现：这份报告是从住院和门诊records.Results的审查汇编：在第一个案例中，一个28岁的女人被认为是左腿腘和小腿深静脉血栓形成没有明显的原因。她描述了长期的小腿不适，左脚被动背屈导致踏板水平的动脉搏动消失。给予抗凝剂肝素和华法林钠（香豆素），随后进行手术探查。腘静脉和动脉被附着在股骨外侧髁上的腓肠肌内侧头的纤维延伸所夹持。在带松解后，患者已无症状6年。第二例患者为37岁男性，患有双侧慢性静脉功能不全（CVI）。被动背屈和主动跖屈的脚并没有减少踏板脉搏;阻抗体积描记法表明轻度流出道阻塞。上行静脉造影显示在重复腘静脉的中部卡压，无血栓形成后变化。他接受了弹力袜治疗，在18个月的随访中表现良好。第3例患者为17岁男性，自3岁起出现右腿CVI和静脉阻塞的严重症状。空气体积描记术显示动态静脉高压，而静脉造影显示反流下降到膝盖，在中腘静脉外源性狭窄。术中发现小隐静脉（LSV）异常起源于腘静脉; LSV走内侧路线，压迫胫神经，导致腘静脉严重扭曲和狭窄。分裂的LSV导致释放腘静脉压迫和立即缓解symptoms.Conclusions：这三个案件表明，腘静脉卡压可能开始与深静脉血栓形成和CVI的症状。在缺乏常见诱发因素的年轻患者中，静脉疾病的鉴别诊断必须考虑腘静脉嵌压。
Purpose: This report describes popliteal vein entrapment in three patients and demonstrates that it may present with manifestations of typical venous disease.Methods: This report was compiled from a review of inpatient and outpatient records.Results: In the first case, a 28-year-old woman was seen with left leg popliteal and calf deep vein thrombosis without obvious cause. She described long-standing calf discomfort, and passive dorsiflexion of the left foot caused disappearance of arterial pulsations at the pedal level. She was given the anticoagulants heparin and sodium warfarin (Coumadin) followed by surgical exploration. The popliteal vein and artery were entrapped by a fibrous extension of the medial head of the gastrocnemius muscle attaching to the lateral femoral condyle. After band lysis, the patient has been symptom free for 6 years. The second patient, a 37-year-old man, was seen with bilateral chronic venous insufficiency (CVI). Passive dorsiflexion and active plantar flexion of the feet did not diminish the pedal pulses; impedance plethysmography suggested mild outflow obstruction. Ascending venography demonstrated entrapment at the midportion of duplicated popliteal veins with no postthrombotic changes. He was treated with compression stockings and has done well during an 18-month follow-up. The third patient, a 17-year-old male, was seen with severe symptoms of right leg CVI and venous obstruction since 3 years of age. Air plethysmography revealed ambulatory venous hypertension, whereas venography demonstrated reflux down to the knee with an extrinsic narrowing at the midpopliteal vein. During operation, an abnormal origin of the lesser saphenous vein (LSV) from the popliteal vein was found; the LSV took a medial route, compressed the tibial nerve, and caused severe distortion and narrowing of the popliteal vein. Division of the LSV resulted in release of popliteal venous compression and immediate relief of symptoms.Conclusions: The three cases presented demonstrate that popliteal venous entrapment may begin with symptoms of deep vein thrombosis and CVI. Popliteal venous entrapment must be considered in the differential diagnosis of venous disease in younger patients in whom common predisposing factors are absent.