Une claudication atypique par piège poplité fonctionnel

Abstract

Popliteal artery entrapment syndrome is infrequent. One form less well recognized has no anatomic abnormality.A 22-year old man, with a medical history of chronic compartment syndrome treated surgically by aponeurectomy, had developed intermittent claudication of both legs with plantar paresthesia. Active plantar flexion of the ankle reduced distal pulses and doppler ultrasound waveforms. Popliteal artery entrapment syndrome was suspected and was confirmed by dynamic angiography. Because no arterial ou muscular abnormalities were found, we diagnosed a functional popliteal entrapment syndrome. Surgical treatment permitted rapid functional improvement.Positional occlusion of the popliteal artery is a normal physiologic variant that may become pathologic with muscle overuse or traumatic injury. It causes neuromuscular claudication by compressing the neurovascular bundle at the level of the soleal sling. Diagnosis is based on dynamic color-flow duplex imaging and magnetic resonance angiography. Surgical treatment is indicated only for symptomatic patients and consists of fasciotomy, resecting the compressing structures with a posterior or medial approach.