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The "functional" popliteal entrapment syndrome.
Summary
This case report details a trained athlete with popliteal artery entrapment syndrome causing intermittent claudication. Dynamic angiography revealed arterial occlusion, highlighting functional entrapment due to muscle development, distinct from anatomical causes.
Area of Science:
- Vascular Surgery
- Sports Medicine
- Diagnostic Imaging
Background:
- Popliteal artery entrapment syndrome (PAES) can cause exertional leg pain.
- Diagnosis can be challenging, especially in athletes with high muscle mass.
Observation:
- A highly trained athlete presented with intermittent claudication during running.
- Neutral angiograms were normal, but dynamic angiograms during plantar flexion showed complete bilateral popliteal artery occlusion.
- Surgical exploration revealed no anatomical abnormalities or entrapment points.
Findings:
- The patient's PAES was attributed to functional entrapment caused by muscular hyperdevelopment, not organic anatomical abnormalities.
- This case introduces the concept of 'functional entrapment' versus 'organic, anatomical entrapment' in PAES.
Implications:
- Dynamic angiography is crucial for diagnosing functional PAES in athletes.
- Surgical exploration is essential to rule out organic entrapment and may be therapeutic for functional cases.