Popliteal artery entrapment by an enlarged sesamoid bone

A 64-year-old woman came to our hospital because of intermittent claudication of her left leg. She had undergone meniscectomy of the left knee in her 30s. The ankle-brachial pressure index of the left leg was 0.70. Imaging examinations showed occlusion of the popliteal artery compressed by an enlarged sesamoid bone with osteophytes. No anatomic abnormalities of vessels and muscles were seen. A particular type of popliteal entrapment syndrome was diagnosed. After resection of the sesamoid bone, thromboendarterectomy and patch plasty were performed. After the operation, the claudication was improved, and the ankle-brachial pressure index of the left leg increased to 0.91.