Natural history of entrapment of the popliteal artery

Popliteal artery entrapment (PAE) is described with increasing frequency. Reviewing the world literature and corresponding with some investigators, we were able to collect 375 instances in 291 patients, including our personal experience (33 instances in 24 patients). The present study was done to establish the natural history and evolution of PAE. Two groups of patients were created to verify if an early diagnosis and treatment of PAE is justified. Group 1 included 129 patients treated by a simple musculotendinous section. In group 2, 226 patients were treated by a vascular procedure (bypass, thromboendarterectomy, other). Age, symptoms and arteriographic findings were the parameters considered in the two groups. Results demonstrated that patients in group 1 are younger than those in group 2 (p < 0.001). Preoperative symptoms demonstrated a larger number of mild symptoms (paresthesias, a cold foot and cramping after intensive physical training) in group 1, when compared with group 2 (p < 0.001). Arteriography demonstrated a larger number of patients with normal findings at rest, with popliteal stenosis or occlusion during maneuver, in group 1 than in group 2 (p < 0.001). PAE results in progressive arterial impairment. Early noninvasive screening is mandatory to detect PAE at an early stage. Surgical treatment is thereby limited to a musculotendinous section, which has the best results.