[Compression syndromes in the popliteal area]

In young, active patients with intermittent or sudden-onset ischemic pain in the lower leg, the presence of an entrapment syndrome of the popliteal artery must be considered. This compression syndrome can be clinically and angiographically verified by an interruption in the continuity of the middle segment of the artery. As irritation of the arterial wall can lead to complete occlusion of the artery, all cases of entrapment syndrome within the popliteal fossa--even those causing few symptoms or none at all--require surgical revision. A dorsal approach should be used, and the anatomical variations of the artery listed elsewhere must be considered. The surrounding musculature on the fibrous structures causing compression must be incised or resected; in some cases vascular reconstruction is necessary. In the relatively rare soleus syndrome, there is entrapment of nerves and veins as well as of the artery. In such cases, the tendon of the soleus muscle must be split to obtain adequate decompression of the vascular nerve bundle.