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Total Popliteal Artery Occlusion after Stent Insertion Diagnosed as Popliteal Artery Entrapment Syndrome

잘못된 Stent 삽입 치료 후 슬와 동맥 포착 증후군에서 발생한 슬와 동맥의 완전 폐쇄 1예

  • Kim, Eun Hye (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Lee, In-Sun (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Kim, Seong-Hwan (Divison of Cardiology, Yonsei Cardiovascular Center, Yonsei University College of Medicine) ;
  • Shin, Sang-Hun (Divison of Cardiology, Yonsei Cardiovascular Center, Yonsei University College of Medicine) ;
  • Lee, Taek-Yeon (Department of Cardiovascular Surgery, Yonsei University College of Medicine) ;
  • Lee, Do-Yun (Department of Radiology, Yonsei University College of Medicine) ;
  • Choi, Donghoon (Divison of Cardiology, Yonsei Cardiovascular Center, Yonsei University College of Medicine)
  • 김은혜 (연세대학교 의과대학 내과학교실) ;
  • 이인선 (연세대학교 의과대학 내과학교실) ;
  • 김승환 (연세대학교 의과대학 심장혈관병원 심장내과) ;
  • 신상훈 (연세대학교 의과대학 심장혈관병원 심장내과) ;
  • 이택연 (연세대학교 의과대학 심장혈관외과학교실) ;
  • 이도연 (연세대학교 의과대학 영상의학과학교실) ;
  • 최동훈 (연세대학교 의과대학 심장혈관병원 심장내과)
  • Published : 2012.12.01

Abstract

Entrapment of the popliteal artery is a rare cause of ischemia of the lower extremities in young males. The development of local occlusive or aneurysmal changes of the popliteal artery is caused by abnormal anatomical relationships between vascular and musculotendinous structures in the popliteal fossa. A 55-year-old male patient visited Yonsei University College of Medicine with the chief complaint of claudication in his right calf. He had undergone stent insertion in the right popliteal artery for peripheral artery occlusive disease 2 years earlier. Lower extremity CT angiography showed stent fracture and in-stent thrombosis. He underwent femoral-to-popliteal artery bypass surgery. Postoperative lower extremity CT angiography showed that the vein graft was compressed between the medial head of the gastrocnemius and the semimembranosus muscle. However, the blood flow was normal and his pain was relieved.

슬와 동맥 포착 증후군은 드물지만 적절한 치료를 하지 않을 경우 사지를 잃을 수도 있는 말초혈관 질환으로 주로 젊은 성인에 호발되는 것으로 보고되고 있다. 원인으로는 슬와 동맥과 주변의 근육, 건막 구조물 간의 비정상적인 해부학적 연관관계에 의해서 슬와 동맥이 지속적으로 압박되어 하지 혈류 장애를 초래하는 것이다. 저자들은 간헐적인 우측 하지의 파행과 동통이 있었던 55세 환자에게서 잘못된 스텐트 삽입술 치료 후 발생한 스텐트 골절, 슬와 동맥의 완전폐쇄를 복재 정맥(saphenous vein)을 이용한 혈관 우회술로 치료한 1예를 보고하였다. 슬와 동맥 포착 증후군의 치료는 스텐트 삽입술이 아닌 혈관 우회술 등의 수술적인 치료를 고려하여야 한다.

Keywords

References

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