Surgical Treatment for Popliteal Artery Entrapment Syndrome, a Common Cause of a rare Clinical Entity: Report of One Case

Abstract

Context: Popliteal artery entrapment syndrome (PAES) is a non-atherosclerotic cause of claudication and acute ischemia of the legs in young individuals. Objective: To report on a case of popliteal artery entrapment that was treated surgically. Case report: The patient was a 46-year-old hypertensive male diver who had been experiencing pain in his right leg for around six months, which worsened upon exertion. Physical examination showed absence of posterior tibial pulse and dorsal pulse in the right foot. Arterial duplex scan and angiotomography showed a popliteal artery with a tortuous path that passed behind the medial head of the gastrocnemius muscle, where its lumen was compromised when the knee was extended. This case of PAES was classified as type 1 and the surgical treatment implemented consisted of arterial decompression through sectioning the medial bundle of the gastrocnemius muscle, combined with a popliteal-to-popliteal graft from the great saphenous vein (inverted). Conclusion: Popliteal artery entrapment is a rare syndrome, but it may affect physically active young adults and worsen their quality of life. If this disease is suspected, diagnostic evaluation and surgical treatment need to be performed, and this will probably avoid the risk of losing the limb in cases of irreversible vascular injury.