Popliteal Artery Entrapment Syndrome

Abstract

Popliteal artery entrapment syndrome is a rare clinical entity. Stuart,15 a medical student at the University of Edinburgh in 1879, was the first to describe an anomalous course of the popliteal artery in an amputated leg of a 60-year-old man who developed gangrene of the foot as a result of a large popliteal aneurysm. Haming7 reported the first successful treatment of popliteal artery entrapment syndrome in a 12-year-old boy who developed claudication and was found to have an anomalous course of the popliteal artery. The term popliteal artery entrapment syndrome was first coined by Love and Whelan9 in 1965. Extrinsic compression of the popliteal artery, which is the basis of this syndrome, results from either an abnormal course of the popliteal vessels or an aberrant attachment of the gastrocnemius muscle or plantaris muscle over the normally positioned vessels. On the basis of this finding at the popliteal fossa, Insuaet al.8 have classified these variants into four groups. In patients with type I popliteal artery entrapment syndrome,5 the most commonly found abnormality, the popliteal artery deviates medially to the normally placed medial head of the gastrocnemius muscle. In type II there is an abnormal attachment of the medial deviation of the popliteal artery. The popliteal artery is compressed by a muscle band of the medial head of the gastrocnemius muscle in type III. In type IV a fibrous band of the popliteal muscle causes compression of this artery. Rich and his associates12 described compression of both artery and vein, which is now classified as type V.