Popliteal vein compression: Difference between revisions
Jump to navigation
Jump to search
(Created page with " {{SI}} {{CMG}} '''''Keywords and synonyms:''''' poplitieal vein syndrome, popliteal vein entrapment ==Overview== Popliteal vein compression is a disorder in which there ...") |
|||
| (7 intermediate revisions by the same user not shown) | |||
| Line 1: | Line 1: | ||
__NOTOC__ | |||
{{SI}} | {{SI}} | ||
{{CMG}} | {{CMG}} | ||
| Line 8: | Line 6: | ||
==Overview== | ==Overview== | ||
Popliteal vein compression is a disorder in which there is either anatomic or funcitonal compression of outflow from the [[popliteal vein]]. | Popliteal vein compression is a disorder in which there is either anatomic or funcitonal compression of outflow from the [[popliteal vein]]. | ||
==Pathophysiology== | ==Pathophysiology== | ||
===Anatomic Compression=== | |||
There can be non dynamic / static compression of the vein from extrinsic anatomic structures. In this scenario there is a muscle or fibrous tissue surrounding the vein that is compressing it. | |||
===Functional Compression=== | |||
In this scenario, the calf muscles on either side of the vein are in normal anatomic location, however when the muscle of the calf are tensed, the vein is compressed. There is no fixed anatomic structure compressing the vein, and there is dynamic compression. | |||
==Epidemiology and Demographics== | ==Epidemiology and Demographics== | ||
This is a very rare disorder. | |||
==Risk Factors== | |||
Symptoms may develop in the following scenarios: | |||
* Muscle building exercises in young women | |||
* Recurrence of [[varicose veins]] in the region supplied by the short [[saphenous vein]] | |||
* [[Sural vein]] thrombosis in the absence of [[thrombophilia]] | |||
==Diagnosis== | ==Diagnosis== | ||
===Symptoms=== | ===Symptoms=== | ||
*The patient may be asymptomatic and the disorder can go unrecognized. | *The patient may be asymptomatic and the disorder can go unrecognized. | ||
*[[Muscle cramps]] with exertion | *[[Muscle cramps]] with exertion or prolonged standing | ||
===Physical Examination=== | |||
====Extremities==== | |||
*[[Edema]] or swelling of the lower extremity that is positional | *[[Edema]] or swelling of the lower extremity that is positional | ||
*Non edematous swelling of the calf muscle in athletes | |||
*Asymmetry of the circumference of the [[anterior tibialis muscle]] and the [[posterior tibialis muscle]] | |||
==Laboratory Findings== | ==Laboratory Findings== | ||
===Duplex Ultrasound=== | ===Duplex Ultrasound=== | ||
The diagnosis is confirmed by duplex scanning investigation with active and passive maneuvers, whose aim is to detect the position that triggers this condition | The diagnosis is confirmed by duplex scanning investigation with active and passive maneuvers, whose aim is to detect the position that triggers this condition. | ||
== | ===Dynamic Venography=== | ||
===MRI=== | |||
MRI is more sensitive than ultrasound in detecting compression of the venous structures. | |||
==Treatment== | |||
Although popliteal artery entrapment is a well-defined anatomic entity, whose treatment has received a broad consensus of approval, extrinsic compression of the popliteal vein syndrome, more recently recognized, is rarely systematically sought. Treatment of this condition is subject to differences in terms of methods and indications. Some have proposed the term “popliteal vein entrapment syndrome” to associate so-called “functional forms” and anatomical forms, observed more rarely. An anatomic form involves our ability to specifically see a muscle or fibrous tissue surrounding the vein or artery. A functional form involves our ability to see venous compression on imaging studies, but no evidence of a discrete abnormal structure compressing the vein. | |||
explore the popliteal space of one leg and divide any fibrous tissue or muscle surrounding the vein, and see if this gives you some degree of relief in the postoperative period. | |||
===Complications of Surgery=== | |||
*There can be a long incision post operatively given that the vein must be explored along its entire course. | |||
*Nerve damage | |||
*[[Deep vein thrombosis]] | |||
==References== | |||
{{Reflist|2}} | |||
[[Category:Disease]] | |||
Latest revision as of 15:01, 26 July 2012
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Keywords and synonyms: poplitieal vein syndrome, popliteal vein entrapment
Overview
Popliteal vein compression is a disorder in which there is either anatomic or funcitonal compression of outflow from the popliteal vein.
Pathophysiology
Anatomic Compression
There can be non dynamic / static compression of the vein from extrinsic anatomic structures. In this scenario there is a muscle or fibrous tissue surrounding the vein that is compressing it.
Functional Compression
In this scenario, the calf muscles on either side of the vein are in normal anatomic location, however when the muscle of the calf are tensed, the vein is compressed. There is no fixed anatomic structure compressing the vein, and there is dynamic compression.
Epidemiology and Demographics
This is a very rare disorder.
Risk Factors
Symptoms may develop in the following scenarios:
- Muscle building exercises in young women
- Recurrence of varicose veins in the region supplied by the short saphenous vein
- Sural vein thrombosis in the absence of thrombophilia
Diagnosis
Symptoms
- The patient may be asymptomatic and the disorder can go unrecognized.
- Muscle cramps with exertion or prolonged standing
Physical Examination
Extremities
- Edema or swelling of the lower extremity that is positional
- Non edematous swelling of the calf muscle in athletes
- Asymmetry of the circumference of the anterior tibialis muscle and the posterior tibialis muscle
Laboratory Findings
Duplex Ultrasound
The diagnosis is confirmed by duplex scanning investigation with active and passive maneuvers, whose aim is to detect the position that triggers this condition.
Dynamic Venography
MRI
MRI is more sensitive than ultrasound in detecting compression of the venous structures.
Treatment
Although popliteal artery entrapment is a well-defined anatomic entity, whose treatment has received a broad consensus of approval, extrinsic compression of the popliteal vein syndrome, more recently recognized, is rarely systematically sought. Treatment of this condition is subject to differences in terms of methods and indications. Some have proposed the term “popliteal vein entrapment syndrome” to associate so-called “functional forms” and anatomical forms, observed more rarely. An anatomic form involves our ability to specifically see a muscle or fibrous tissue surrounding the vein or artery. A functional form involves our ability to see venous compression on imaging studies, but no evidence of a discrete abnormal structure compressing the vein. explore the popliteal space of one leg and divide any fibrous tissue or muscle surrounding the vein, and see if this gives you some degree of relief in the postoperative period.
Complications of Surgery
- There can be a long incision post operatively given that the vein must be explored along its entire course.
- Nerve damage
- Deep vein thrombosis