Pathology

FIGURE 62.1 Popliteal vein compression with ankle maneuvers: mid popliteal (left). Discrete lesions at high and low popliteal locations as well as diffuse lesions (not shown) also occur.

The most frequent compressive mechanism is the gas-trocnemius muscle due to abnormalities in the origin of the medial head (see Table 62.1). Postnatal extension of the medial head of the gastrocnemius muscle from the medial femoral condyle to involve portions of the adjacent femoral shaft is a normal event; excessive migration appears to result in compression of the vein. Compression by other muscles

TABLE 62.1 Pathological Features in 30 Cases Undergoing Entrapment Release

Compressive entrapment mechanism

Number

Gastrocnemius Medial Head anomalous origin

18*

Additional 3rd Head of Gastrocnemius

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