[Sub-adventitial rupture of the popliteal artery and recurrent ischemia: a diagnostic pitfall in young patients]

In the absence of thromboembolic risk factors, signs of thrombosis in situ, or disorders of coagulation, two possible diagnoses must be envisaged when acute recurring ischemia is observed in a peripheral area of tissue: extrinsic compression or rupture of an arterial coat, especially when the subject is young and in good general health. The case of a 35 year old patient presenting with recurring ischemia in the popliteal artery of the right lower limb due to sub-adventitial rupture of the popliteal artery suggests three comments: the period of latency (3 months) between initial trauma to the popliteal artery and the operation of reverse saphenous vein bypass, the necessity for dynamic manipulations together with angiographic and ultrasound examination, the probable underestimation of the traumatic or functional causes of this disorder (popliteal artery), and the surgical prognosis remains excellent.