The popliteal artery entrapment syndrome is a rather uncommon pathology

Pathology

Pathology is the precise study and diagnosis of disease. The word pathology is from Ancient Greek , pathos, "feeling, suffering"; and , -logia, "the study of". Pathologization, to pathologize, refers to the process of defining a condition or behavior as pathological, e.g. pathological gambling....

, which results into claudication

Claudication

Claudication, literally 'limping' , is a medical term usually referring to impairment in walking, or pain, discomfort or tiredness in the legs that occurs during walking and is relieved by rest. The perceived level of pain from claudication can be mild to extremely severe. Claudication is most...

 and chronic leg ischemia

Ischemia

In medicine, ischemia is a restriction in blood supply, generally due to factors in the blood vessels, with resultant damage or dysfunction of tissue. It may also be spelled ischaemia or ischæmia...

. The popliteal artery

Popliteal artery

In human anatomy, the popliteal artery is defined as the extension of the "superficial" femoral artery after passing through the adductor canal and adductor hiatus above the knee...

 may be compressed behind the knee

Knee

The knee joint joins the thigh with the leg and consists of two articulations: one between the fibula and tibia, and one between the femur and patella. It is the largest joint in the human body and is very complicated. The knee is a mobile trocho-ginglymus , which permits flexion and extension as...

, due to congenital deformity of the muscle

Muscle

Muscle is a contractile tissue of animals and is derived from the mesodermal layer of embryonic germ cells. Muscle cells contain contractile filaments that move past each other and change the size of the cell. They are classified as skeletal, cardiac, or smooth muscles. Their function is to...

s or tendon

Tendon

A tendon is a tough band of fibrous connective tissue that usually connects muscle to bone and is capable of withstanding tension. Tendons are similar to ligaments and fasciae as they are all made of collagen except that ligaments join one bone to another bone, and fasciae connect muscles to other...

 insertions of the popliteal space. This repetitive trauma may result in stenotic

Stenosis

A stenosis is an abnormal narrowing in a blood vessel or other tubular organ or structure.It is also sometimes called a stricture ....

 artery degeneration, complete artery occlusion

Vascular occlusion

Vascular occlusion is a sudden blockage of a blood vessel, usually with a clot. It differs from thrombosis in that it can be used to describe any form of blockage, not just one formed by a clot. When it occurs in a major vein, it can, in some cases, cause deep vein thrombosis. The condition is...

 or even formation of an aneurysm

Aneurysm

An aneurysm or aneurism is a localized, blood-filled balloon-like bulge in the wall of a blood vessel. Aneurysms can commonly occur in arteries at the base of the brain and an aortic aneurysm occurs in the main artery carrying blood from the left ventricle of the heart...

.

History

The syndrome was first described in 1879 by Anderson Stuart, a medical student

Medical Student

Medical Student may refer to:*Someone studying at medical school*Medical Student Newspaper, a UK publication...

, in a 64-year-old male. Hamming and Vink in 1959 first described the management of the popliteal artery syndrome in a 12-year-old patient. The patient was treated with myotomy

Myotomy

Myotomy describes a surgical procedure in which muscle is cut.A common example of a myotomy is the Heller myotomy....

 of the medial head of the gastrocnemius muscle

Gastrocnemius muscle

In humans, the gastrocnemius muscle is a very powerful superficial pennate muscle that is in the back part of the lower leg. It runs from its two heads just above the knee to the heel, and is involved in standing, walking, running and jumping. Along with the soleus muscle it forms the calf muscle...

 and concomitant endarterectomy

Endarterectomy

Endarterectomy is a surgical procedure to remove the atheromatous plaque material, or blockage, in the lining of an artery constricted by the buildup of soft/hardening deposits. It is carried out by separating the plaque from the arterial wall....

 of the popliteal artery. They later reported four more cases and claimed that the incidence of this pathology in patients younger than 30 years old with claudication was 40%. Servello was the first to draw attention to diminished distal pulses observed with forced plantar- or dorsiflexion in patients suffering from this syndrome. Bouhoutsos and Daskalakis in 1981 reported 45 cases of this syndrome in a population of 20,000 Greek soldiers. During the recent years the increasing frequency with which popliteal artery entrapment is reported, strongly suggests a greater awareness of the syndrome.

Classification

Love and Whelan proposed a classification of this pathology into four types, according to the various relationships between the popliteal artery and the muscles of the popliteal space. Rich and Hughes described popliteal vein

Popliteal vein

The popliteal vein course runs alongside the popliteal artery but carries the blood from the knee joint and muscles in the thigh and calf back to the heart.Its origin is defined by the junction of the posterior tibial vein and anterior tibial vein....

compression, thus adding a fifth type into the former classification. The functional type of the popliteal vessel compression was first described by Rignault et al. in 1985 and labeled by Levien as type VI of the popliteal vessels entrapment syndrome.

External links

• Surgical Rounds - N. Saratzis, A. Saratzis. Popliteal Artery Entrapment Syndrome. Surgical Rounds. January 2006. Cover article.