Bilateral Popliteal Artery Entrapment Syndrome: An Approach to Diagnosis and Salvage

Abstract

Popliteal artery entrapment syndrome (PAES) is a rare cause of limb-threatening vascular disease. Usually, it arises from aberrant embryological development or acquired dysfunctionality of the popliteal artery and its surrounding musculotendinous structures in the popliteal fossa. Here, we present a case report of a young woman with relatively sudden-onset short-distance claudication and paraesthesia affecting her right leg primarily. She had no recent traumatic history and no atherosclerotic risk factors and was otherwise previously very active. She had a feeble right popliteal artery pulse and no foot pulses. Nerve conduction studies demonstrated no electrophysiological abnormalities. Following computed tomography angiography and magnetic resonance imaging, it was determined she had type 2 PAES. Subsequently, the patient underwent surgical division of a lateralised head of her medial gastrocnemius, resection of her fibrosed popliteal artery, and repair with a reversed long saphenous vein interposition graft. Following surgery, her symptoms resolved, and she remains on aspirin and ultrasound surveillance.

(Popliteal artery entrapment syndrome)

“…Onemocnění se vyskytuje častěji u mladších mužů, sportovců, s nízkým kardiovaskulárním rizikem a až v 60 % případů se může jednat o oboustranné postižení. 2 Udávaná incidence PAES se pohybuje v rozmezí 0,6-3,5 %. 1 PAES byl poprvé zaznamenán v roce 1879 studentem medicíny Stuartem, který během pitvy popsal výrazně aneurysmaticky rozšířenou a. poplitea a její anomální průběh mediálně od mediální hlavy musculus gastrocnemius.…”