What Are The Ways To Prevent Popliteal Artery Entrapment Syndrome & Does It Reoccur?

Surgery is the most recommended option to relieve compression of the calf muscle. It can prevent the constriction of the artery by the calf muscle in future.^1,2

Popliteal artery entrapment syndrome is a rare abnormality in the leg. Due to recurrent symptoms, surgical intervention is often advocated.^3,4

Popliteal artery entrapment syndrome is a disorder that affects the legs. It is one of the biggest arteries of the body and runs behind the legs. When this artery is compressed, it restricts the blood flow and eventually damages the artery causing leg pain and cramps.

In athletes susceptible to PAES, exercise results in swelling of these muscles and enhances the likelihood of artery compression, which can cause leg pain and other warning signs.

Popliteal artery entrapment syndrome (PAES) was described more than a hundred years ago by Stuart in 1879 as an uncommon limb-threatening vascular entity. PAES happens when adjacent tendons and muscles put pressure on the popliteal artery.

PAES is typically a hereditary complication, meaning you are congenital with the disorder. PAES is most common in young athletes, who play athletic sports (football, soccer & rugby) or involved in strenuous weightlifting activities.¹

There are no ways to prevent the disorder however early diagnosis and proper treatment can prevent the condition before getting worsened. Since popliteal artery entrapment syndrome is associated with how the popliteal artery and nearby tendons grow as we are born and mature, it cannot be prevented. It is very essential to have a high degree of suspicion in these patients as the complication can be very devastating when not properly treated. Most cases of PAES are asymptomatic therefore careful history and focussed physical examination can be paramount.

However, the symptomatic condition is diagnosed through Doppler ultrasound and other diagnostic techniques (Computed tomography, magnetic resonance imaging, and angiography). Surgery is the most recommended option of choice in symptomatic PAES patients to relieve compression of the calf muscle. It can prevent the constriction of the artery by the calf muscle in the future. Although surgery can be therapeutic, it is accompanied by its own set of potential problems.

In a worst-case scenario, long-lasting muscle or nerve impairment can happen due to compression or loss of blood flow to the lower leg.^2,3

The surgical and endovascular treatments produced potential outcomes and studies showed that there were no intraoperative or postoperative complications. These patients were monitored over 5 years and they were not required any long-term follow-ups after the therapeutic approaches.

However, very rare cases had recurrent thrombosis of the popliteal artery after treatment and the treatment was repeated in two phases. After repeated therapies and subsequent follow-ups, there were no-longer symptoms.

On the contrary, when the condition was left untreated, the artery was more compressed and as a result, there was a reduced blood flow and resulted in severe cramping and pain in the calf muscles during exercise and activities. Since the pathophysiology of popliteal artery entrapment syndrome showed that they had a secondary effect in the long-term, repetitive trauma was usually noticed and anomalies were noticed in the popliteal artery which acts as a dominant source of blood supply.⁴

Recurrent trauma to the artery can result in permanent damage to the muscles and nerves of the leg.

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