Aneurysm of the Popliteal Artery Caused By Osteochondroma of the Femur

Denman, Frank R.; Shindler, Thomas O.; Hampton, James M.; L, Hanson

doi:10.2106/00004623-195941080-00013

Cited by 22 publications

(6 citation statements)

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“…Although this is not usually the case, in this particular case the thrill disappeared and it was absent in other reported cases [8][9][10][11] where they were misdiagnosed initially. In the Marcove et al case, 10 the aneurysm biopsied was mistaken for a bony tumor, while in the Denman et al case, 17 biopsy of the aneurysm was mistakenly performed because of the absence of the thrill and palpable impulse. This happened because the slow blood flow in the aneurysmal sac caused a thrombosis which eventually led to compression of the artery.…”

Section: Discussionmentioning

confidence: 99%

Pseudoaneurysm of Popliteal Artery Secondary to Hereditary Multiple Exostoses: Case Report

Qattan

Jawdat

Al-Sabti

1994

Annals of Saudi Medicine

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The popliteal artery is the most common site of peripheral aneurysmal formation. Arteriosclerosis, syphilis and mycotic infection are the most common etiological factors while in young adults, the aneurysm is often of the false type and caused by trauma. 1,2 Osteochondroma around the knee joint can give rise to such pathology that was first described by Brailsfords in 1953 3,4 followed by a more detailed account by Paul in the same year. 5Since that time, approximately 27 cases have been reported in the English literature, including ours. [6][7][8][9][10]16,[20][21][22] Case ReportA 23-year-old Saudi male was referred from another hospital with a history of severe pain and swelling in the right lower limb which occurred during jogging. The patient experienced difficulty in walking due to the pain and the decreased movement of the knee, but no pain at rest. There was a family history of hereditary multiple exostoses (HME).Physical examination showed diaphoretic skin, marked swelling of the right posterior lower extremity distal to the mid thigh primarily behind the knee. There was increased warmth and tenderness and palpable popliteal pulse. A thrill was reported early at the referring hospital, but disappeared after arrival at our hospital. All pedal pulses were palpable. The ankle/brachial pressure was 0.8. We recommended medical advice and treatment to the members of the family who were suffering from HME but the family refused. InvestigationPlain x-ray showed multiple osteochondroma over the left shoulder and left knee (Figure 1). Computed tomography (CT) and angiogram showed a false aneurysm at the popliteal artery with bony spikes originating from both femurs (Figures 2 and 3). This was performed in the referral hospital. Magnetic resonance imaging (MRI) performed at our hospital confirmed the presence of a large pseudoaneurysm which showed areas of decreased signal, signifying flow and a small area of hematoma seen medially (Figure 4).

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Section: Discussionmentioning

confidence: 99%

Pseudoaneurysm of Popliteal Artery Secondary to Hereditary Multiple Exostoses: Case Report

Qattan

Jawdat

Al-Sabti

1994

Annals of Saudi Medicine

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“… 7–19 It is generally accepted that mechanical irritation and trauma to the vessel by the tumour results in a breach of the vessel wall, with resultant false aneurysm formation. 3,10,14,16,20–25 The majority of these pseudoaneurysms tend to occur in the popliteal fossa as a consequence of the inherent frequency of osteochondromas to arise at the knee, coupled with local vascular anatomical factors at this site, namely the relative immobility of the popliteal artery as it emerges from the adductor canal. 4,5,9,19,22,24–28 The presenting patient did not have a palpable popliteal pulsatile mass pre‐operatively and, indeed, no pseudoaneurysm was observed at surgery, although some degree of poststenotic dilatation of the vessel was present.…”

Section: Discussionmentioning

confidence: 99%

Popliteal Artery Compression by a Tibial Osteochondroma With Associated Thrombosis and Distal Embolization

Hemli

Barakate

Puttaswamy

et al. 2000

Aust. N.Z. J. Surg.

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“…1,9,12 Operation is recommended because of the risk of distal embolization. 15 After excision, the wall of the artery should be approximated if possible, 6 and end-to-end anastomosis, 8 saphenous vein grafting, 1 or a synthetic graft 2 carried out. The osteochondroma should then be excised.…”

Section: Discussionmentioning

confidence: 99%