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What Are The Non-Surgical Treatment Options For Popliteal Artery Entrapment Syndrome?

Popliteal artery entrapment syndrome results in chronic disability in young adults and sports personalities with abnormal anatomic connections 1.

Despite non-surgical treatment, the patients were able to resume their normal routine after 2 days of the procedure. 2. 3.

Early diagnosis with reduced damage in the arteries can restore normal blood flow with exercising and resting. 4.

Popliteal Artery Entrapment Syndrome (PAES) is a rare vascular disease, an anomaly resulting in symptomatic extrinsic compression between the popliteal artery and the surrounding musculotendinous structures.

It most commonly affects the legs of young adults and sports personalities under the age of 30, who are prone to frequent leg movements.

What Are The Non-Surgical Treatment Options For Popliteal Artery Entrapment Syndrome?

The treatment of choice is often dependent on anatomy and diagnostic procedure of the condition. Despite scientific innovations in arterial repair, pain, and damage to the popliteal artery continue to be related to a comparatively elevated amputation ratio in most civilian and military practices.

If the condition is diagnosed in their initial stages and the artery remains undamaged, it is much easier to relieve the compression of the structures, restore the normal blood flow and ease the pain. This is typically done with sufficient resting and exercising conditions. 1.

However, when the condition progresses and compression built for a long time, it eventually damages the lining of the artery which in turn causes permanent structural damages in the artery. When there is damage, it may block the artery. When the plague builds up and blocks the arteries, it can lead to heart attack and stroke. It will be no longer possible to relieve the external compression and restore blood flow for the damaged arteries.

When the condition is diagnosed correctly (a careful diagnostic evaluation is carried out) and appropriate treatment is taken to correct the problem, clinical studies show that these patients have shown the best long-term outcomes.

BTX-A (Botulinum Toxin) Injection – Medical studies were conducted to find a viable alternative to surgical intervention and to find the best treatment for popliteal artery entrapment syndrome. This was carried out through an ultrasound-guided BTX-A (Botulinum toxin) injection.

Botulinum toxin is a naturally occurring toxin generated by gram-positive bacteria that helps stop muscle spasms. They are very effective in the management of neurogenic detrusor hyperactivity in children and young adults. Patients provided with this injection showed improvement in their symptoms and no patients reported being worse after this subjective treatment. 2. 3.

Endovascular Procedure- These are minimally invasive procedures (non-surgical methods) that are performed inside the blood vessels and are found to be very effective in the treatment of popliteal artery entrapment syndrome. The procedure is generally done when there is a sudden loss of brain functions due to blood clots. Clinical studies demonstrate that a 51-year old man who was experiencing pale, cold right foot was treated with endovascular therapy. He was treated through catheter-directed thrombolysis and percutaneous transluminal angioplasty.

His symptoms improvised and he was able to return to normal life without progressing to claudication. A three-year follow-up was conducted on this patient and the results showed good clinical outcomes suggesting that endovascular therapy can produce significant results and known to be a proven alternative to surgical procedures. 4.


  1. Radonić, V, et al. “Popliteal Artery Entrapment Syndrome: Diagnosis and Management, with Report of Three Cases.” Texas Heart Institute Journal, U.S. National Library of Medicine, 2000, www.ncbi.nlm.nih.gov/pmc/articles/PMC101010/.
  2. McGinley, Joseph C. “Nonsurgical Treatment of Cystic Adventitial Disease of the Popliteal Artery Caused by Functional Popliteal Artery Entrapment Syndrome.” Journal of Vascular Surgery Cases, Elsevier, 18 Mar. 2015, www.sciencedirect.com/science/article/pii/S2352667X15000223.
  3. Ozkan, Ugur. “Endovascular Treatment of Popliteal Artery Entrapment Syndrome: Technical Aspects and Results of Endovascular Treatment With Surgical Release of Popliteal Artery.” Vascular Disease Management, www.vasculardiseasemanagement.com/content/endovascular-treatment-popliteal-artery-entrapment-syndrome-technical-aspects-and-results.
  4. “Popliteal Artery Entrapment Syndrome.” University of Maryland Medical Center, www.umms.org/ummc/health-services/heart-vascular/services/vascular-disease/conditions/popliteal-artery-entrapment-syndrome
Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:June 8, 2020

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