Popliteal Artery Entrapment Syndrome

Popliteal artery entrapment syndrome is an important albeit infrequent cause of seriousdisability among young adults and athletes with anomalous anatomic relationshipsbetween the popliteal artery and surrounding musculotendinous structures. We reportour experience with 3 patients, in whom we used duplex ultrasonography, computedtomography, digital subtraction angiography, and conventional arteriography to diagnosepopliteal artery entrapment and to grade the severity of dynamic circulatory insufficien-cy and arterial damage.We used a posterior surgical approach to give the best view of the anatomic struc-tures compressing the popliteal artery. In 2 patients, in whom compression had not yetdamaged the arterial wall, operative decompression of the artery by resection of theaberrant muscle was su fficient. In the 3rd patient, operative reconstruction of an occlud -ed segment with autologous vein graft was necessary, in addition to decompression ofthe vessel and resection of aberrant muscle. The result in each case was complete re-covery, with absence of symptoms and with patency verified by Doppler examination.We conclude that clinicians who encounter young patients with progressive lower-limb arterial insufficiency should be aware of the possibility of popliteal artery entrap-ment. Early diagnosis through a combined approach (careful physical examination andhistory-taking, duplex ultrasonography, computerized tomography, and angiography) isnecessary for exact diagnosis. The treatment of choice is the surgical creation of normalanatomy within the popliteal fossa.