Popliteal Artery Entrapment Syndrome

Abstract

In this series of patients with surgically confirmed PAES, we found preoperative DUS to have perfect agreement with the intraoperative findings in diagnosing PAES. The applicability of the method seems to be emphasized by the restoration of popliteal flow and relief of arterial insufficiency after surgical release in all patients, and by the fact, that none of the healthy volunteers were able to compress the popliteal artery during plantar flexion.

Case report and literature review of popliteal artery entrapment syndrome

“…4 Doppler ultrasound is a non-invasive modality that provides a good overview of the popliteal fossa, popliteal artery, and arterial flow at a reasonable cost. 10 Magnetic resonance angiography and CTA allow physicians to visualize the popliteal fossa and arterial anomalies, providing better arterial depiction than ultrasonography with excellent visualization of stenosis, dilation, and arterial wall abnormalities. 9 Furthermore, magnetic resonance angiography with high-contrast resolution offers precise analysis of muscle courses and their potential conflict with popliteal vessels as well as allowing classification, making it ideal for diagnosis.…”

Functional Popliteal Artery Entrapment Syndrome: Poorly Understood and Frequently Missed? A Review of Clinical Features, Appropriate Investigations, and Treatment Options

“…Despite PAES being a well-defined condition, no clear-cut consensus regarding the diagnostic work-up of these patients exists [ 20 ]. The general population can be divided into four groups, including asymptomatic nonoccluders, who presumably will not present for assessment or investigation.…”

“…Some authors recommend the use of ankle brachial indices in standard work-up for functional PAES [ 3 ]. However, as occlusion in functional PAES occurs during exertion, testing after exercise is likely to result in a false negative result [ 20 ]. There are also difficulties in obtaining ABI measurements during exercise [ 18 ] and Pillai suggests that ABIs during forceful plantarflexion are difficult to interpret and not as helpful when assessing graded compression of a patent artery [ 17 ].…”

“…Doppler ultrasound provides a relatively cheap, noninvasive, and accessible procedure to assess flow through the popliteal artery, and it is generally recommended that this be the first line investigation for PAES [ 20 , 21 ]. Despite this, a review of the literature shows no definite consensus on how to perform Doppler ultrasound in investigating PAES [ 20 ]. Some authors suggest hand held Doppler units to complement clinical assessment in the rooms.…”

“…Ultrasound is a useful modality, as it allows real time assessment whilst some form of provocation to reproduce symptoms is performed. Despite the agreement that provocation is necessary, a clear and detailed description of the protocols to do this is generally not provided [ 20 ]. Our protocols are included below for completeness.…”