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Popliteal artery entrapment syndrome.
Stanley Bradshaw1, Peiman Habibollahi1, Jayesh Soni1
1Division of Vascular and Interventional Radiology, Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Cardiovascular Diagnosis and Therapy
|November 24, 2021
Summary
Popliteal artery entrapment syndrome (PAES) causes leg pain in young athletes due to external artery compression. Early diagnosis and treatment are crucial to prevent serious complications like limb loss.
Area of Science:
- Vascular Surgery
- Sports Medicine
- Diagnostic Imaging
Background:
- Popliteal artery entrapment syndrome (PAES) is a rare cause of exertional leg pain in young, active individuals.
- It results from external compression of the popliteal artery due to developmental anomalies.
- PAES typically presents as intermittent claudication after exercise, relieved by rest.
Purpose of the Study:
- To highlight the importance of early diagnosis and intervention in PAES.
- To review diagnostic modalities for identifying PAES and its subtypes.
- To discuss treatment strategies and outcomes for PAES.
Main Methods:
- Review of clinical presentations and diagnostic approaches for PAES.
- Emphasis on non-invasive tests like Ankle Brachial Index and Doppler ultrasound with provocative maneuvers.
- Advanced imaging techniques such as CT angiography (CTA) and MR angiography (MRA) with provocative maneuvers are discussed.
Main Results:
- PAES affects young athletes without traditional atherosclerotic risk factors.
- CTA and MRA demonstrate high sensitivity and specificity in diagnosing PAES and characterizing its subtypes.
- Six subtypes of PAES exist, based on the anatomical relationship between the artery and surrounding structures.
Conclusions:
- Prompt evaluation of exertional claudication in young individuals is essential for PAES diagnosis.
- Accurate imaging (CTA/MRA) is vital for subtype characterization and surgical planning.
- Myotendinous decompression, with or without vascular repair, is the definitive treatment, offering satisfactory long-term outcomes if circulation is preserved.
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