NEW: Popliteal Entrapment Syndrome – Dynamic Imaging

29-year-old female with right leg pain after hiking/stair climbing. History of prior fasciotomies for presumed chronic recurrent exertional compartment syndrome (CRECS).

Figure A-B: Resting (A) and stress imaging with active plantarflexion (B).

A. Axial images at the knee show an accessory muscle adjacent to the right lateral gastrocnemius head (L). The popliteal artery
(arrow) is wide patent at rest. M = medial head of gastrocnemius. * = accessory muscle near lateral head of gastrocnemius.

B. Stress images show marked narrowing of the popliteal artery (arrow) between the accessory muscle and the medial
gastrocnemius head. Note the left knee does not show similar findings.

Patient demographics:
Height: 166 cm
Weight: 64 kg

CTA injection parameters:
Scan time: 8 sec
Diagnostic (“trigger”) delay: 5 sec
Bolus triggering: above the knee
popliteal artery
Tube energy: 120 kVp

Contrast concentration: 370 mgI/mL
Contrast volume: 72 mL
Contrast flow rate: 4 mL/sec
Saline flush volume: 25 mL
Saline flow rate: 4 mL/sec

Note: injection and scan performed twice for resting and “active plantarflexion” imaging.

Figure C-D. 3D Volume-rendered (VR) images of both knees, viewed from posterior.

C. Resting images show no popliteal artery narrowing on either side (arrow = right popliteal artery).

D. Stress images with active plantarflexion show occlusion of the right popliteal artery (arrow). The left popliteal artery is widely
patent.

Figure E-F. 3D VR images viewed from posterior, with opacity transfer function set to highlight muscle.

E. Resting image shows accessory muscle on the right (arrow) but no compression of the popliteal artery (arrowhead).

F. Stress image with active plantarflexion shows contraction of the accessory muscle (arrow) and complete occlusion of the adjacent
right popliteal artery (arrowhead). The left side is normal by comparison.

All images, protocols, and outcomes are courtesy of Dr. Richard Hallett, Banner University Medical Center - Phoenix, Phoenix, AZ.
Individual results may vary.

IMPORTANT SAFETY INFORMATION  |  INDICATIONS AND USAGE

EmpowerCTA®+ Injector System

Caution: Federal law restricts this device to sale by or on the order of a physician.

INDICATIONS:

The EmpowerCTA®+ Injector System is indicated for the vascular administration of contrast and flushing media in conjunction with computed tomography (CT) scanning of the body with an optional interface to a CT scanner and an optional calculator for glomerular filtration rate (GFR).

EmpowerCTA®+ Injector System

Caution: Federal law restricts this device to sale by or on the order of a physician.

INDICATIONS:

The EmpowerCTA®+ Injector System is indicated for the vascular administration of contrast and flushing media in conjunction with computed tomography (CT) scanning of the body with an optional interface to a CT scanner and an optional calculator for glomerular filtration rate (GFR).

Protocols have been independently developed and are not intended as medical advice. Bracco and Bracco Injeneering S.A. shall not be responsible for any physicians’ reliance on these or any other products.

CONTRAINDICATIONS:

The EmpowerCTA®+ Injector System is not intended for use as a long-term infusion pump, nor is it intended to be used to inject any agents other than contrast or flushing media. Do not attempt to use the injector for any other purpose (such as chemotherapy or drug infusion). The EmpowerCTA+ Injector System should not be used to inject substances into nonvascular body cavities. Any applications of the EmpowerCTA+ Injector System other than those described in its Operator Manual are inappropriate and should not be attempted.

Not all products are available in all global markets.

EmpowerCTA+ is distributed by Bracco Diagnostics Inc.; 259 Prospect Plains Road, Bldg. H; Monroe Township, NJ 08831 USA; Phone: (800) 631-5245; Fax: (609) 514-2424; Customer Service: 1-877-BRACCO 9 (1-877-272-2269); Scientific Information: 1-800-257-5181 (Option 2); EmpowerCTA+ Email: empowerinfo@diag.bracco.com; Website: https://smartinject.wpenginepowered.com/ct-solutions/

EmpowerCTA+ is manufactured by Bracco Injeneering S.A., Avenue de Sevelin 46, CH – 1004 Lausanne, Switzerland. https://www.bracco.com/

 

EmpowerMR® Injector System

Caution: Federal law restricts this device to sale by or on the order of a physician.

INDICATIONS:

The EmpowerMR® Injector System is indicated for vascular administration of contrast media and flushing media in conjunction with magnetic resonance imaging (MRI).

Protocols have been independently developed and are not intended as medical advice, and Bracco shall not be responsible for any physicians' reliance on these or any other protocols.

Bracco Injeneering S.A. reserves the right at any time and without notice, to change the specifications and features described herein, or to change the production or adjust the product described.

Not all products are available in all global markets.

EmpowerMR is distributed by Bracco Diagnostics Inc.; 259 Prospect Plains Road, Bldg. H; Monroe Township, NJ 08831 USA; Phone: (800) 631-5245; Fax: (609) 514-2424; Customer Service: 1-877-BRACCO 9 (1-877-272-2269); Scientific Information: 1-800-257-5181 (Option 2); Website: https://smartinject.wpenginepowered.com/mr-solutions/

EmpowerMR is manufactured for Bracco Injeneering S.A., Avenue de Sevelin 46 CH – 1004 Lausanne, Switzerland. https://www.bracco.com/

 

NEXO® Contrast Management System

Intended Use:

The NEXO® Contrast Management System is a server-based application intended to be used as a data management and visualization system. The NEXO Contrast Management System can read, store, share, compare/relate, as well as graphically display data and injection programs coming from RIS, PACS, and multiple enabled EmpowerCTA® Injector Systems. This device provides users with record lists, graphics, and reports about data and performances.

This device is intended for retrospective and statistical data management and visualization. It is not intended for real-time data visualization, diagnostic applications, or for any other use for which the device is not indicated. This device is only to be operated by and under quasi-continuous supervision of qualified and trained staff in an appropriately licensed healthcare facility.

The NEXO Contrast Management System is compatible with the EmpowerCTA Injector System version 8.0, and EmpowerCTA®+ Injector System version 10.0 and higher.

Not all products are available in all global markets.

NEXO is distributed by Bracco Diagnostics Inc.; 259 Prospect Plains Road, Building H; Monroe Township, NJ 08831 USA; Phone: (800) 631-5245; Fax: (609) 514-2424; NEXO Customer Service: 1-877-BRACCO 9 (1-877-272-2269); NEXO questions: Nexo.Answers@diag.bracco.com; NEXO U.S. Technical Service and Support: Phone: 888-670-7701; Fax: 609-514-2448; NEXO Email: customer.support@acistmedical.com; Website: https://smartinject.wpenginepowered.com/digital-solutions

NEXO is manufactured by ACIST Medical Systems, 7905 Full Road, Eden Prairie, MN 55344 USA.

 

About Bracco Injeneering S.A.

Bracco Injeneering S.A., located in Lausanne, Switzerland, is the most recently added Business Unit of Bracco Imaging. Bracco Injeneering is committed to developing the best-in-class, integrated injection solutions with a strong heritage in research and innovation. It provides quality solutions for state-of-the-art radiology centers, offering proven injection technology, built on Bracco Imaging’s expertise.

Thanks to this strengthened product portfolio, including the EmpowerCTA®+ Injector System and EmpowerMR Injector System Bracco Imaging will be able to focus on constant innovation, not only for devices but also for software development and data management.

EmpowerCTA, EmpowerMR, NEXO, and IRiSMR are registered trademarks of Bracco Injeneering S.A., registered in the U.S.

FastLoad is a trademark of Bracco Injeneering S.A.

All other trademarks and registered trademarks are the property of their respective owners.