Popliteal artery entrapment syndrome occurs when the popliteal artery, the main artery for the lower body, is compressed by muscles behind the knee, restricting blood flow through the legs.

The disease presents in two ways: congenitally and developmentally.

Congenital variations are present at birth when the course of the artery is altered by one of the muscles in the area behind the knee. This can remain without symptoms or can cause significant problems if the artery becomes compressed and eventually blocked.

Developed conditions are usually seen in athletes and competitive runners when the muscles are in the correct position but compress the artery as they grow.

How is popliteal artery entrapment syndrome diagnosed?

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This is a difficult diagnosis in many centers because most physicians do not expect vascular disease to occur in young patients. This can delay the diagnosis.

There are also other diagnoses that can mimic popliteal artery entrapment, like chronic compartment syndrome of the lower extremity, knee joint pain, or other problems with the muscles in this area.

The diagnosis is made by non-invasive testing using MRI, MRA or CT scan with contrast. We also use ultrasound-based, non-invasive vascular lab testing, and measurements of the flow and pressures.

In cases which are difficult, such as those with functional PAES, we often have to perform an angiogram, in which the patient moves the leg in different ways to induce the symptoms and we measure blood flow under these conditions.