Popliteal entrapment syndrome – thrombolysis

Popliteal thrombolysis. This young patient developed acute thrombosis of the left popliteal artery (CT image, arrow) due to a condition called popliteal entrapment syndrome. In this syndrome, the anatomical relationship between the artery and one or more of the adjacent muscles (usually gastrocnemius) is developmentally abnormal and results in compression of the artery. It can present with symptoms of intermittent claudication or acute ischaemia. in this case, the site of the thrombosis is clearly demonstrated on the subsequent angiogram, bottom left, indicated by the yellow arrow. The contrast has been injected through a catheter advanced through the femoral artery (orange arrow). A thrombolysis catheter was then inserted and tPA (tissue plasminogen activator) was infused for 48 hours. Subsequent angiogram shows complete resolution of the thrombus.