Skip to main content

Advertisement

SpringerLink
Log in

Popliteal Artery Entrapment Syndrome

  • Injury Clinic
  • Published:
Sports Medicine Aims and scope Submit manuscript

Abstract

Popliteal artery entrapment syndrome (PAES) is a rare cause of exercise-induced leg pain. Entrapment occurs because of an abnormal relationship between the popliteal artery and the surrounding myofascial structures in the popliteal fossa. Arterial insufficiency in the affected limb arises with entrapment of the artery, commonly giving leg symptoms with exertion.

The true incidence of PAES in the general population is not known. The aetiology of PAES has an embryological basis related to the development of the popliteal artery and the surrounding musculature. Many different classification schemes have been developed to differentiate the various types of abnormal anatomy that are associated with the syndrome. Repeated popliteal artery compression causes trauma to the arterial wall, leading to premature localised atherosclerosis. The pathology of PAES is believed to be progressive, with arterial thrombosis occurring in some individuals as a natural progression of the disease process. Acute ischaemia can occur if there is an occlusion of the artery or thrombosis within an aneurysm.

Clinically, up to 85% of individuals diagnosed with the syndrome are males. The mean age of individuals in a large series was 28 years. The condition can be found bilaterally in 25% of cases. Most individuals present with exercise-induced leg pain, the remainder presenting with acute or chronic ischaemia.

The condition can result in significant functional loss for active individuals. Surgery has been advocated to prevent the progression of the disease that is believed to be the natural history of untreated PAES. However, the little research that has been done to determine the prognosis for individualswho have undergone surgery has focused on the patency rate of the arteries after surgery and the presence or absence of complications. Research needs to be done to look at the natural history of untreated PAES and the functional status of athletes after undergoing PAES surgery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Stuart TP. Note on a variation in the course of the popliteal artery. J Anat Physiol 1879; 13: 162

    PubMed  CAS  Google Scholar 

  2. Eastcott HH. Popliteal entrapment: an epilogue. Aust NZ J Surg 1986; 56: 865–9

    Article  CAS  Google Scholar 

  3. Chambardel-Dubreuil LL. Variations des arteres du pelvis et du membre inferieur. Paris: Masson & Cie, 1925

    Google Scholar 

  4. Hamming JJ. Intermittent claudication at an early age, due to an anomalous course of the popliteal artery. Angiology 1959; 10: 369–71

    Article  PubMed  CAS  Google Scholar 

  5. Love JW, Whelan TJ. Popliteal artery entrapment syndrome. Am J Surg 1965; 109: 620–4

    Article  PubMed  CAS  Google Scholar 

  6. Murray A, Halliday M, Croft RJ. Popliteal artery entrapment syndrome. Br J Surg 1991; 78: 1414–9

    Article  PubMed  CAS  Google Scholar 

  7. di Marzo L, Cavallaro A, Sciacca V, et al. Surgical treatment of popliteal artery entrapment syndrome: a ten-year experience. Eur J Vasc Surg 1991; 5: 59–64

    Article  PubMed  Google Scholar 

  8. Carter AE, Eban R. A case of bilateral development abnormalities of the popliteal arteries and gastrocnemius muscles. Br J Surg 1964; 51: 518–22

    Article  PubMed  CAS  Google Scholar 

  9. Senior HD. The development of the arteries of the human lower extremity. Am J Anat 1919; 25: 55–9

    Article  Google Scholar 

  10. Rignault DP, Pailler JL, Lunel F. The ‘functional’ popliteal entrapment syndrome. Int Angiol 1985; 4: 341–3

    PubMed  CAS  Google Scholar 

  11. Turnipseed WD, Pozniak M. Popliteal entrapment as a result of neurovascular compression by the soleus and plantaris muscles. J Vasc Surg 1992; 15: 285–94

    Article  PubMed  CAS  Google Scholar 

  12. Gibson MH, Mills JG, Johnson GE, et al. Popliteal entrapment syndrome. Ann Surg 1977; 185: 341–8

    Article  PubMed  CAS  Google Scholar 

  13. Jenal G, Allenberg JR. Der PoplitealverschluB-Urasche, Therapie, Fruh und Spatergebnisse. Angio Archiv 1985; 8: 183–6

    Google Scholar 

  14. Brunner U, Bronz L, Bronz G. Der chronische Poplitealverschlu B. In: Denck H, Hagmuller GW, editors. (HRSG) Das Therapiekonzept beim chronischen Femoropoplitealen Arterienschlu B. Vienna: Egerman, 1977: 225–37

    Google Scholar 

  15. Zund G, Brunner U. Surgical aspects of popliteal artery entrapment syndrome: 26 years of experience with 26 legs. Vasa 1995; 24 (1): 29–33

    Google Scholar 

  16. Duwellius PJ, Kelbel JM, Jardon OM. Popliteal artery entrapment in a high school athlete: a case report. Am J Sports Med 1987; 15 (4): 371–3

    Article  Google Scholar 

  17. Cohn SL, Taylor WC. Vascular problems of the lower extremity in athletes. Clin Sports Med 1990; 9 (2): 449–70

    PubMed  CAS  Google Scholar 

  18. Collins PS, McDonald PT, Lim RC. Popliteal artery entrapment syndrome: an evolving syndrome. J Vasc Surg 1989; 10: 484–90

    PubMed  CAS  Google Scholar 

  19. di Marzo L, Cavallaro A, Mingoli A, et al. Popliteal artery entrapment syndrome: the role of early diagnosis and treatment. Surgery 1997; 122: 26–31

    Article  PubMed  CAS  Google Scholar 

  20. Cummings RJ, Webb HW, Lovell WW, et al. The popliteal artery entrapment syndrome in children. J Pediatr Orthop 1992; 12 (4): 539–41

    Article  PubMed  CAS  Google Scholar 

  21. Whelan TJ. Popliteal artery entrapment syndrome. In: Hamovici H, editor. Vascular surgery. New York: McGraw-Hill, 1976: 493

    Google Scholar 

  22. Berg-Johnsen J, Holter O. Popliteal artery entrapment syndrome. Acta Chir Scand 1984; 150: 493–6

    PubMed  CAS  Google Scholar 

  23. Insua JA, Young JR, Humphries AW. Popliteal artery entrapment syndrome. Arch Surg 1970; 101: 771–5

    Article  PubMed  CAS  Google Scholar 

  24. Delaney TA, Gonzalez LL. Occlusion of the popliteal artery due to muscular entrapment. Surgery 1971; 69: 97–101

    PubMed  CAS  Google Scholar 

  25. Rich NM, Collins GJ, McDonald PT, et al. Popliteal vascular entrapment. Arch Surg 1979; 114: 1377–94

    Article  PubMed  CAS  Google Scholar 

  26. Ferrero R, Barile C, Bretto P, et al. Popliteal artery entrapment syndrome. J Cardiovasc Surg 1980; 21: 45–52

    CAS  Google Scholar 

  27. Fong H, Downs AR. Popliteal artery entrapment syndrome with distal embolization: a report of two cases. J Cardiovasc Surg 1989; 30: 85–8

    CAS  Google Scholar 

  28. Ikeda M, Iwase T, Ashida K, et al. Popliteal artery entrapment syndrome: report of a case and study of 18 cases in Japan. Am J Surg 1981; 141: 726–30

    Article  PubMed  CAS  Google Scholar 

  29. Schurmann G, Mattfeldt T, Hofmann W, et al. The popliteal artery entrapment syndrome: presentation, morphology and surgical treatment of 13 cases. Eur J Vasc Surg 1990; 4: 223–31

    Article  PubMed  CAS  Google Scholar 

  30. Madigan RR, McCampbell BR. Thrombosis of a popliteal artery in a jogger: a case report. J Bone Joint Surg 1981; 63A: 1490

    Google Scholar 

  31. Turner GR, Gosney WG, Ellingson W, et al. Popliteal artery entrapment syndrome. JAMA 1969; 208: 692

    Article  PubMed  CAS  Google Scholar 

  32. Barbaras AP. Popliteal artery entrapment syndrome. Br J Hosp Med 1985; 34 (5): 304

    Google Scholar 

  33. Gaylis H, Rosenburg B. Popliteal artery entrapment syndrome. S Afr Med J 1972; 46: 1071–5

    PubMed  CAS  Google Scholar 

  34. McDonald PT, Easterbrook JA, Rich NM, et al. Popliteal artery entrapment syndrome: clinical, noninvasive and angiographic diagnosis. Am J Surg 1980; 139: 318–25

    Article  PubMed  CAS  Google Scholar 

  35. Rich NM, Hughes CW. Popliteal artery and vein entrapment. Am J Surg 1967; 113: 696–8

    Article  PubMed  CAS  Google Scholar 

  36. Darling RC, Buckley CJ, Abbott WM, et al. Intermittent claudication in young athletes: popliteal artery entrapment syndrome. J Trauma 1974; 14: 543–52

    Article  PubMed  CAS  Google Scholar 

  37. Erdoes LS, Devine JJ, Bernhard VM, et al. Popliteal vascular compression in a normal population. J Vasc Surg 1989; 20: 978–86

    Article  Google Scholar 

  38. Zeuchner J, Geitung JT, Lukes P, et al. Angiography and colour flow Duplex ultrasonography in the evaluation of peripheral ischemic occlusive arterial disease. Acta Radiol 1994; 35 (4): 270–4

    PubMed  CAS  Google Scholar 

  39. di Marzo L, Cavallaro A, Sciacca V, et al. Diagnosis of popliteal artery entrapment syndrome: the role of duplex scanning. J Vasc Surg 1991; 13: 434–8

    Article  PubMed  Google Scholar 

  40. Akkersdijk WL, de Ruyter JW, Lapham R, et al. Colour duplex ultrasonographic imaging and provocation of popliteal artery compression. Eur J Endovasc Surg 1995; 10: 342–5

    Article  CAS  Google Scholar 

  41. Rudo HD, Noble HB, Conn J. Popliteal artery entrapment syndrome in athletes. Phys Sports Med 1982; 10: 105

    Google Scholar 

  42. Gyftokostas D, Koutsoumbelis C, Mattheou T, et al. Post stenotic aneurysm in popliteal artery entrapment syndrome. J Cardiovasc Surg 1991; 32: 350–2

    CAS  Google Scholar 

  43. Houston JG, Forster L, Machan L, et al. Comparison of dynamic 2D time-of-flight MR angiography with digital angiography in popliteal artery entrapment syndrome. Can Assoc Radiol J 1997; 48: 11–8

    PubMed  Google Scholar 

  44. Clanton TO, Solcher BW. Chronic leg pain in the athlete. Clin Sports Med 1994; 13 (4): 743–67

    PubMed  CAS  Google Scholar 

  45. Fujiwara H, Sugano T, Fujii N. Popliteal artery entrapment syndrome: accurate morphological diagnosis utilizing MRI. J Cardiovasc Surg 1992; 33: 160–2

    CAS  Google Scholar 

  46. Hoelting T, Schuermann G, Allenberg JR. Entrapment of the popliteal artery and its surgical management in a 20-year period. Br J Surg 1997; 84: 338–41

    Article  PubMed  CAS  Google Scholar 

  47. Rosset E, Hartung O, Brunet C, et al. Popliteal artery entrapment syndrome, anatomic and embryologic bases, diagnostic and therapeutic considerations following a series of 15 cases with a review of the literature. Surg Radiol Anat 1995; 17: 161–9

    Article  PubMed  CAS  Google Scholar 

  48. Lambert AW, Wilkins DC. Popliteal artery entrapment syndrome: collaborative experience of the Joint Vascular Research Group. Br J Surg 1998; 85: 1367–8

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Allan McGavin Sports Medicine Centre, University of British Columbia, Vancouver, British Columbia, Canada

    Andrew Stager & Douglas Clement

Authors
  1. Andrew Stager
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Douglas Clement
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Stager, A., Clement, D. Popliteal Artery Entrapment Syndrome. Sports Med 28, 61–70 (1999). https://doi.org/10.2165/00007256-199928010-00006

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00007256-199928010-00006

Keywords

Search

Navigation