A Case of Popliteal Artery Entrapment Syndrome Using Intraoperative Indocyanine Green Fluorescence Angiography

Abstract

A 50-year-old man presented with severe intermittent claudication of the left lower limb. An enhanced CT and MRI demonstrated occlusion of the left popliteal artery due to malposition of the medial head of the gastrocnemius muscle. Popliteal artery entrapment syndrome (PAES) was diagnosed. Surgical procedure was performed with posterior approach, and the accessory slip of the medial head of the gastrocnemius muscle was removed, which compressed the popliteal artery. Intraoperative indocyanine green (ICG) fluorescence angiography demonstrated the popliteal artery was occluded, therefore it was replaced with the great saphenous vein. The postoperative course was uneventful, and intermittent claudication completely disappeared. Intraoperative ICG fluorescence angiography was useful in determining whether revascularization should be performed during surgery for PAES.