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Popliteal Artery Entrapment Syndrome
1Cleveland Clinic, Independence, OH.
Current Sports Medicine Reports
|September 12, 2015
Summary
Popliteal artery entrapment syndrome (PAES) causes exertional leg pain in active people and is likely underdiagnosed. Diagnosis involves imaging, with treatment tailored to individual needs for return to activity.
Area of Science:
- Vascular Surgery
- Sports Medicine
- Diagnostic Imaging
Background:
- Popliteal artery entrapment syndrome (PAES) is a rare but likely underdiagnosed cause of exertional lower leg pain in active individuals.
- Symptoms include cramping and paresthesias relieved by rest, often with a benign physical examination.
Purpose of the Study:
- To review the diagnostic modalities and treatment options for popliteal artery entrapment syndrome.
- To emphasize the importance of considering PAES in active individuals with exertional leg pain.
Main Methods:
- Review of diagnostic approaches, starting with noninvasive ultrasound with Doppler and provocative maneuvers.
- Discussion of advanced imaging like MRI/MRA and arteriography for identifying specific obstructions.
- Consideration of historical surgical treatment versus proposed less invasive interventions.
Main Results:
- Imaging is crucial for assessing anatomical variations and functional entrapment of the popliteal artery.
- Noninvasive testing should be the initial diagnostic step when PAES is suspected.
- Surgical exploration has been the traditional treatment, but less invasive options are emerging.
Conclusions:
- Popliteal artery entrapment syndrome requires a high index of suspicion in active individuals with exertional leg pain.
- Diagnostic workup should progress from noninvasive to advanced imaging as needed.
- Treatment decisions for PAES are individualized, with most patients returning to high-level training.
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