Botulinum toxin treatment is found to be a viable alternative to surgery for patients with functional popliteal artery entrapment syndrome.1
BTX-A temporarily reduced muscle tone and promoted localized atrophy and the entrapment was also relieved.2
Patients who experienced exercise-induced leg pain completely resumed their normal level of sports and other physical activities after they were treated with BTX-A.3,4
Functional popliteal artery entrapment syndrome (FPAES) is a rare condition of exercise-induced leg soreness. When the muscles get larger, there is a higher probability of compression leading to PAES.
Peripheral artery entrapment syndrome often referred to as over-use injury. When there were no noticeable complications most patients were cured of their symptoms without the need for surgical procedures.
How Effective Is Botox For Popliteal Artery Entrapment Syndrome?
Popliteal artery entrapment syndrome in the absence of proper diagnosis and treatment increases the risk of limb ischemia, damage in the arteries, and poor quality of life for many patients nationwide. This condition is well-managed with surgical myotomy and myomectomy. However, studies were conducted to determine the success rate of a newer treatment botulinum toxin A injection to this uncommon type of claudication.
Botox injections use a toxin called onabotulinum toxin A that can temporarily paralyze muscles by blocking signals from nerves to the muscles and benefits the popliteal artery entrapment syndrome patients in a multitude of ways. It helps inhibit muscle spasms when the injection is directly applied to the muscles. Botulinum injections are often used when there is an eye movement disorder, cervical dystonia, and chronic migraines however, studies have demonstrated that they are found effective in the treatment of popliteal artery entrapment syndrome.2
A clinical study was conducted on 133 patients who reported symptoms of PAES. Among those 57% were female and the rest were male. Most of these patients experienced recurrent symptoms and underwent duplex ultrasounds. Out of the 133 patients, 7% of the patients underwent a surgical procedure, and the rest of the patients were treated with botulinum injection. Complications were identified in surgical procedure patients however patients who were treated with botox showed significant improvement in their symptoms and did not require imaging techniques in the following months. They were monitored over ten months and no complications were reported.
The analysis demonstrated that Botox can be used as a viable alternative and an effective therapeutic measure for PAES patients. They can be used as a new constructive therapeutic strategy in reducing the functional structures and improve artery functions.3,4
Diagnosis Of Popliteal Artery Entrapment Syndrome
The primary symptoms of popliteal artery entrapment syndrome are pain or cramp in the lower leg or calf muscle that occurs during movements. However, this condition resolves with rest. Popliteal artery entrapment syndrome is generally diagnosed through
Duplex Ultrasonography- This procedure is found successful in many vascular diseases and to diagnose arterial narrowing and lesions. A combination of ultrasonography and magnetic resonance imaging techniques provides the best diagnosis.
Computed Tomography- CT provides comprehensive evidence on the wall and diameter of the artery and its abnormal structures in its surrounding areas.
Digital Subtraction Angiography (DSA)- Findings using DSA for each limb provides much effective results. The diagnosis demonstrated both the vascular changes and the anatomic variations.
Conventional Arteriography- This is a traditional gold standard exploration for the diagnosis of popliteal artery entrapment syndrome to identify the clinical features and anomalies in the arteries.1
- Isner-Horobeti ME;Muff G;Masat J;Daussin JL;Dufour SP;Lecocq J; “Botulinum Toxin as a Treatment for Functional Popliteal Artery Entrapment Syndrome.” Medicine and
- Science in Sports and Exercise, U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/25290742/.
- “Botulinum Toxin Injection for Functional Popliteal Artery Entrapment Syndrome – Full Text View.” Full Text View – ClinicalTrials.gov, clinicaltrials.gov/ct2/show/NCT03631966.
- Schultz, M., et al. “Botulinum Toxin: A New Treatment for Functional Popliteal Artery Entrapment Syndrome? Five Patients Relieved More than One Year.” Annals of Physical and Rehabilitation Medicine, Elsevier Masson, 13 July 2018, www.sciencedirect.com/science/article/pii/S1877065718302379.
- “Botulinum Toxin Injection for Functional Popliteal Artery Entrapment Syndrome.” Stanford Health Care (SHC) – Stanford Medical Center, stanfordhealthcare.org/trials/b/NCT03631966.html.