Popliteal artery entrapment syndrome with thrombosed popliteal aneurysm: multidetector computed tomography angiography findings of a case Bulent Karaman a , Bilal Battal a, ⁎ , Veysel Akgun b , Salih Hamcan a , Yalcin Bozkurt a , Ugur Bozlar a a Department of Radiology, Gulhane Military Medical School, 06018, Etlik, Ankara, Turkey b Department of Radiology, Golcuk Military Hospital, 41650, Golcuk, Kocaeli, Turkey Received 10 November 2011; received in revised form 1 December 2011; accepted 3 January 2012 Abstract Popliteal artery entrapment syndrome (PAES) is a rare congenital vascular pathology caused by the compression of the popliteal artery by adjacent muscle and tendinous structures. Popliteal artery aneurysm associated with this syndrome is extremely rare. A 45-year-old male suffering from pain at the right lower extremity during exercise was admitted to our hospital. Physical examination and Doppler imaging revealed a weak pulse at the posterior tibial artery and no pulse at dorsalis pedis and anterior tibial arteries. The patient was further evaluated with multidetector computed tomography angiography (MDCTA). MDCTA revealed PAES due to compression of the accessory fibers of the gastrocnemius muscle and related thrombosed popliteal aneurysm. © 2012 Elsevier Inc. All rights reserved. Keywords: Popliteal artery; Entrapment syndrome; MDCT angiography; Thrombosed aneurysm 1. Introduction Popliteal artery entrapment syndrome (PAES) is a rare congenital vascular pathology caused by the compression of popliteal artery by adjacent muscle and tendinous struc- tures. This entity is most commonly seen in young men with lower extremity ischemic symptoms. It is first described in an amputated leg in 1879. Extrinsic arterial compression causes chronic vascular micro trauma, early arteriosclerosis, and thrombus formation leading to distal ischemia. PAES usually presents with claudication and calf pain during exercise [1–6]. In a recent study, various anomalous anatomic features of muscles and arteries in the popliteal fossa leading to arterial compression were reported [2]. The most commonly used classification of PAES was determined by Love and Whalen [3] and modified by Rich et al. [4] (Table 1). Angiography is still the modality of choice to demonstrate the aneurysm and luminal narrowing. But this technique may not reveal the underlying cause of the entrapment syndrome and aneurysm. In this article, we report the multidetector computed tomography angiography (MDCTA) findings of a rare case with type 3 PAES associated with thrombosed popliteal aneurysm. 2. Case report A 45-year-old male patient suffering from right lower extremity pain during exercise was admitted to our hospital. This complaint had been lasting almost for a year and worsened in the last week. The patient had no complaint Clinical Imaging 36 (2012) 850 – 853 ⁎ Corresponding author. Department of Radiology, Gulhane Military Medical School, 06018, Etlik, Ankara, Turkey. Tel.: +90 533 4330667; fax: +90 312 326 0551. E-mail addresses: bilbat_23@yahoo.com, bbattal77@gmail.com (B. Battal). 0899-7071/$ – see front matter © 2012 Elsevier Inc. All rights reserved. http://dx.doi.org/10.1016/j.clinimag.2012.01.014