Materiały źródłowe

• #1 Popliteal entrapment syndromes – UpToDate

  https://www.uptodate.com/contents/popliteal-entrapment-syndromes

  Popliteal entrapment syndrome (PES) is a condition in which the anatomic relationship between the neurovascular structures of the popliteal fossa and nearby musculotendinous structures is abnormal. Popliteal artery entrapment is the most common form, and popliteal artery compression can reduce blood flow to the leg causing ischemic symptoms. […] PES is an overall rare condition, but its prevalence has increased in recent years likely because of increased awareness in the medical community. The overall prevalence of PES is estimated to range from 0.17 to 3.5 percent of the general population. […] Congenital popliteal entrapment (types I to VI) is a result of abnormal fetal development and migration of the popliteal artery and/or vein in relation to the muscles in the leg, resulting in displacement or compression of the popliteal artery.

• #2 Popliteal artery entrapment syndrome | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/popliteal-artery-entrapment-syndrome?lang=us

  Popliteal artery entrapment syndrome refers to symptomatic compression or occlusion of the popliteal artery due to a developmentally abnormal positioning of the popliteal artery in relation to its surrounding structures such as with the medial head of gastrocnemius or less commonly with popliteus or fibrous bands. […] The anatomic anomalies may be seen in up to 3-3.5% of the population and are often bilateral 2 (~2/3 of cases). […] Individuals with well-developed muscles are more likely to be symptomatic, which probably explains why the syndrome is most often found in young sportspersons (~60 % in those 30 years) with a male-to-female ratio of 15:1 3. […] Arterial compression can result in chronic vascular microtrauma, local premature arteriosclerosis, and thrombus formation. […] This can result in distal ischemia.

• #3 Long-Term Results of Surgical Treatment for Popliteal Artery Entrapment Syndrome

  https://www.mdpi.com/2075-4418/14/12/1302

  The early formation of the distal portion of the popliteal artery and the delayed migration of the proximal head of the medial gastrocnemius muscle cause the first and second types of compressive mechanisms. […] In the absence of anatomical abnormalities, hypertrophy of the medial and lateral portions of the gastrocnemius muscles intermittently causes compression of the popliteal artery during plantar flexion, resulting in the sixth type of this syndrome, known as the functional subtype. […] The exact incidence of PES is not clear. Clinical studies report an incidence of 0.17%, while post-mortem studies suggest an incidence of 3.5%. In a similar study performed by the Popliteal Vascular Entrapment Forum, an incidence of 4.3% was recorded on 162 limbs. […] Most patients affected by PES are predominantly young (in their early 30 s) males (83%). Hypertrophy of the medial gastrocnemius muscle observed in athletes has been widely linked to functional PAES, with approximately 60% of reported cases affecting young athletes under 30 years.

• #4 Popliteal Artery Entrapment Syndrome | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/27432

  Both congenital and acquired mechanisms have been proposed in the development of PAES. An in-depth understanding of the various stages of human embryological development has successfully demonstrated the precise etiology of the congenital PAES. Developmentally, the popliteal artery and the medial head of the gastrocnemius muscle develop about the same time. Both femoral and sciatic artery contributes significantly to the development of the popliteal artery. It originates from the extension of the femoral artery proximally and the sciatic artery distally. Additionally, the sciatic artery contributes to the development of the tibial arteries as well. Over time, the sciatic artery regresses, and femoral artery becomes the main contributor to the development of the popliteal artery. […] The embryological phases of the plantaris muscles play a significant contribution to the congenital PAES. The plantaris muscle is related to the superficial group of the posterior crural muscular tissues and has a pivotal function in the plantar flexion of the ankle joint. However, this muscle is almost vestigial and assumed to act in combination with the gastrocnemius. Furthermore, it has been reported to be aberrant in approximately 10% of the cases as well. When this muscle develops aberrantly, it has the potential to trap the popliteal artery leading to the sign and symptoms of the claudication.

• #5 Long-Term Results of Surgical Treatment for Popliteal Artery Entrapment Syndrome

  https://www.mdpi.com/2075-4418/14/12/1302

  Our study focuses on popliteal artery entrapment syndrome (PAES), in which, in most cases, the vascular injury or mechanical compression requires surgical correction due to aberrant interaction between the popliteal artery and the muscular-tendon structures in the popliteal fossa. […] The proximal part of the popliteal artery originates as a continuation of the superficial femoral artery, which originates from the fusion of the ischiatic artery and the femoral artery. Meanwhile, the union of the tibialis anterior and tibioperoneal trunk forms the distal part, which occurs prior to the migration of the head portion of the medial part of the gastrocnemius into the medial location of the popliteal fossa. […] The most encountered variation of a muscle in PAES is that of the medial head of the gastrocnemius muscle. In humans, the muscle mass that is to make up the future medial head of the gastrocnemius muscle migrates across the popliteal fossa from its original lateral position.

• #6 Popliteal Artery Entrapment Syndrome | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/27432

  Furthermore, various anomalies regarding the relative position of the popliteal artery, medial head of the gastrocnemius (MHG) and popliteus muscles define the multiple types of PAES. Also, the aberrant migration of the medial head during embryological development can result in malpositioning of the muscle concerning the nearby vessels. Interestingly, most of the people born with this congenital anomaly mostly remain asymptomatic, suggesting a likely multifactorial process contributing to disease progression. Although this pathology is present from birth, it appears later, likely due to changes related to use of the gastrocnemius muscle in activities such as running or marching causing muscle hypertrophy with external compression and impingement of the popliteal artery by the medial head.

• #7 Popliteal artery entrapment syndrome – Wikipedia

  https://en.wikipedia.org/wiki/Popliteal_artery_entrapment_syndrome

  The popliteal artery entrapment syndrome (PAES) is an uncommon pathology that occurs when the popliteal artery is compressed by the surrounding popliteal fossa myofascial structures. […] This condition mainly occurs more in young athletes than in the elderlies. […] Newborns and young children are also at increased PAES risk due to congenital causes. During embryonic development, the medial head of gastrocnemius migrates medially and superiorly. This migration can cause structural abnormalities, such as irregular positioning of the popliteal artery, and can account for the rare instances of entrapment caused by the popliteus muscle. […] PAES can be classified as either congenital or functional. […] The varying types of PAES can be classified based on aberrant migration and resultant attachments of the medial head of the gastrocnemius muscle. Type VI PAES (functional PAES) describes a subtype that is due to repeated microtrauma resulting in the destruction of the internal elastic lamina and damage to the smooth muscles resulting in fibrosis and scar formation.

• #8 Popliteal Artery Entrapment Syndrome | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/27432

  Both congenital and acquired mechanisms have been proposed in the development of PAES. An in-depth understanding of the various stages of human embryological development has successfully demonstrated the precise etiology of the congenital PAES. Developmentally, the popliteal artery and the medial head of the gastrocnemius muscle develop about the same time. Both femoral and sciatic artery contributes significantly to the development of the popliteal artery. It originates from the extension of the femoral artery proximally and the sciatic artery distally. Additionally, the sciatic artery contributes to the development of the tibial arteries as well. Over time, the sciatic artery regresses, and femoral artery becomes the main contributor to the development of the popliteal artery. […] The embryological phases of the plantaris muscles play a significant contribution to the congenital PAES. The plantaris muscle is related to the superficial group of the posterior crural muscular tissues and has a pivotal function in the plantar flexion of the ankle joint. However, this muscle is almost vestigial and assumed to act in combination with the gastrocnemius. Furthermore, it has been reported to be aberrant in approximately 10% of the cases as well. When this muscle develops aberrantly, it has the potential to trap the popliteal artery leading to the sign and symptoms of the claudication.

• #9 Popliteal Artery Entrapment Syndrome – MD Searchlight

  https://mdsearchlight.com/health/popliteal-artery-entrapment-syndrome/?utm_source=pubmedlink&utm_campaign=MDS&utm_content=27432

  Popliteal Artery Entrapment Syndrome (PAES) develops from both inborn (congenital) and acquired factors. […] Specifically, the popliteal arterythe blood vessel behind your kneeand one part of your calf muscle (medial head of the gastrocnemius) form around the same time. […] The development of another muscle in your calf, the plantaris muscle, can also play a role in whether a person is born with PAES. […] Other abnormalities can contribute to PAES too. […] However, its important to realize that many people born with these abnormalities dont experience any symptoms, indicating theres probably more than one factor at play in how the disease develops. […] Though youre born with these abnormalities, symptoms often dont show up until later. […] This muscle growth can externally compress the popliteal artery, pinching it against the medial head of the gastrocnemius.

• #10 Popliteal artery entrapment syndrome | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/popliteal-artery-entrapment-syndrome?lang=us

  Stenosis and turbulent flow may lead to post-stenotic ectasia or aneurysm formation. […] Five anatomic types of entrapment are typically described 1: type I: popliteal artery has an aberrant medial course around the medial head of the gastrocnemius, type II: artery is not displaced, but the medial head of gastrocnemius inserts more lateral than usual; the artery passes medial and beneath the muscle, type III: an accessory slip of the medial head of gastrocnemius slings around the artery, type IV: artery lies deep in popliteal fossa entrapped by popliteus or fibrous band, type V: both popliteal artery and vein are entrapped. […] Type VI is also described by some of the literature, which is functional and is caused by gastrocnemius muscle hypertrophy 15.

• #11 Type 2 popliteal artery entrapment syndrome: a case report – Turkish Journal of Thoracic and Cardiovascular Surgery

  https://tgkdc.dergisi.org/text.php?lang=en&id=1681

  Popliteal artery entrapment syndrome is a rare cause of lower limb claudication. The impingement of the popliteal artery can be caused by various relationships between the popliteal artery and the gastrocnemius muscle and other structures in the popliteal fossa, and these can lead to a classification of the syndrome. The particular classification system used today was proposed by Insua et al. in 1970, and there are four main types. In type 1, the medial head of the gastrocnemius muscle is attached in its regular position (the medial condyle of the femur), but the popliteal artery follows an abnormal tract medially around the medial head of the muscle. In type 2, the popliteal artery, which normally follows its natural tract, is impinged by the aberrant medial head of the gastrocnemius muscle, which is originating from a position more lateral to its natural position. In type 3, both the artery and the muscle are in their natural anatomic positions, but aberrant slips of the muscle from the medial head of the gastrocnemius muscle entrap the artery. In type 4, the popliteal artery is entrapped by the fibrous bands originating from the popliteus muscle. Additionally, if there is any type of impingement which involves the popliteal vein, it is defined as type 5. There is also a variant of the PAES in which there are no anatomical anomalies, but the entrapment is caused by the hypertrophic gastrocnemius muscle heads. This is called the functional entrapment syndrome.

• #12 Popliteal Artery Entrapment Syndrome

  https://www.spectrumhealthcare.com.au/blog/?post=popliteal-artery-entrapment-syndrome

  Popliteal artery entrapment syndrome (PAES) is a condition that involves the compression of the popliteal artery or vein as it passes through the popliteal fossa. […] The vascular structures are obstructed by the gastrocnemius, usually during repetitive knee flexion. The repetitive movement causes an overuse response that leads to a gradual thickening of vessel walls due to excessive pressure from the gastrocnemius (Baltopoulos 2004). […] Carneiro described PAES to have six different causes (Carneiro, 2018): Type I: An aberrant medial course of the popliteal artery around a normally positioned head of the medial gastrocnemius, Type II: The medial head of gastrocnemius attaches abnormally and more laterally on the femur causing the popliteal artery to pass medially and inferiorly, Type III: Abnormal fibrous band or accessory muscle arising from the medial or lateral condyle encircling the popliteal artery, Type IV: Popliteal artery lying in its primitive deep or axial position within the fossa, becoming compromised by the popliteus muscle or fibrous bands, Type V: The entrapment of both the popliteal artery and vein due to any of the causes mentioned above, Type VI: The muscular hypertrophy, resulting in a functional compression of both the popliteal artery and vein.

• #13 Popliteal Artery Entrapment Syndrome in a Young Baseball Pitcher: A Ca | JPR

  https://www.dovepress.com/popliteal-artery-entrapment-syndrome-in-a-young-baseball-pitcher-a-cas-peer-reviewed-fulltext-article-JPR

  Popliteal artery entrapment syndrome (PAES) is a rare disease in young adults and is thought to be under-diagnosed, and its main cause is the abnormal structure between the popliteal artery and gastrocnemius muscle. […] PAES is mainly caused by the popliteal artery being compressed by the abnormal muscles and tendons around it, which further leads to vascular claudication. […] In the beginning, PAES was divided into four types according to the differences in anatomical structural abnormalities (relative positions of popliteal artery, medial head of gastrocnemius muscle, and popliteus muscle). […] These 6 types are: (1) type 1: medial head of gastrocnemius muscle position is normal, but popliteal artery abnormally surrounds the medial side of medial head of gastrocnemius muscle; (2) type 2: medial head of gastrocnemius muscle position is abnormal, and its origin is inclined to the lateral side to make the popliteal artery locate at its medial side; (3) type 3: popliteal artery position is normal, but an accessory slip of the medial head of the gastrocnemius muscle abnormally surrounds the two sides of the popliteal artery to compress the popliteal artery; (4) type 4: popliteal artery position is deeper and is compressed by fibrous band or popliteus muscle; (5) type 5: popliteal vein is compressed and its structural abnormality conforms to any type of the four types of compressed popliteal artery; (6) type 6 is functional type, the anatomical positions of the popliteal artery and medial head of the gastrocnemius muscle are normal, but the medial head of the gastrocnemius muscle compresses the popliteal artery due to hypertrophy. […] The main treatment is surgical treatment, and the method is to remove the muscles or tendons of the compressed blood vessels so that the blood flow can be restored.

• #14 Popliteal Artery Entrapment Syndrome: A Case with Bilateral Different Types

  https://www.jchestsurg.org/journal/view.html?doi=10.5090/kjtcs.2014.47.3.302

  Popliteal artery entrapment syndrome (PAES) is a non-artherosclerotic cause of claudication and acute ischemia of the legs in young athletic individuals. […] All types of PAES have the same pathophysiology. Repetitive arterial compression by surrounding structures causes progressive vascular injury. […] Bilateral PAES is reported in about 30% of cases. […] PAES is classified by anatomical position of MHGM. […] If the PopA lies medial to the MHGM, the abnormality is type I. If the MHGM has a lateral attachment to the medial femoral condyle, and the PopA lies medial to the MHGM and is compressed by it, the abnormality is type II. When the PopA is entrapped between the MHGM and an accessory slit, the abnormality is type III. Type IV is the entrapment of the PopA by the popliteus. Any of these abnormalities accompanied by popliteal vein entrapment is referred to as type V. A functional entrapment syndrome, with no evidence of anatomical abnormality but with its symptoms, is type VI.

• #15

  https://journals.lww.com/ijvs/fulltext/2021/08030/popliteal_artery_entrapment_syndrome__our.12.aspx

  The true incidence of popliteal entrapment cannot be estimated due to a lack of awareness, misdiagnosis, and the relative rarity of presentation. […] Popliteal artery entrapment syndrome (PAES) was first characterized in 1879 by Anderson Stuart, which is among one of more unique causes of lower extremity vascular insufficiency. […] It has been proposed that the mechanism of a flexed knee with repeated active plantar flexion while driving a vehicle may result in gastrocnemius muscle hypertrophy causing popliteal artery entrapment. […] The pathology often involves abnormal congenital anatomy surrounding the popliteal artery. […] The different types of PAES are categorized based upon the embryological development of the popliteal fossa. […] Type I entrapment is caused by the popliteal artery forming prior to the migration of the medial head of the gastrocnemius muscle.

• #16 Mayo Clinic Health Library – Popliteal artery entrapment syndrome | Swiss Medical Network

  https://www.swissmedical.net/en/healtcare-library/con-20459610

  Popliteal artery entrapment syndrome (PAES) is caused by an irregular calf muscle, usually the gastrocnemius muscle. […] The condition may be seen at birth, or it may occur later in life. When it’s present at birth, the baby’s calf muscle or nearby artery forms in the wrong place during pregnancy. People who get the condition later in life have a calf muscle that is bigger than usual. […] The changes in the calf muscle cause it to press on the main artery behind the knee. This reduces blood flow to the lower leg. The lack of blood flow causes pain and cramping in the back of the lower leg during times of activity.

• #17 Popliteal Artery Entrapment Syndrome (PAES) Causes and Treatments

  https://www.upmc.com/services/heart-vascular/conditions/popliteal-artery-entrapment-syndrome

  Popliteal artery entrapment syndrome, also called PAES, is a rare vascular disease. […] PAES occurs when nearby tendons and muscles squeeze or compress the popliteal artery. This limits blood flow, leading to symptoms in the lower leg. […] PAES is often a congenital problem, meaning you’re born with the condition. An enlarged calf muscle can also cause PAES to form over time. […] In some cases, compression from PAES can damage and narrow the wall of the popliteal artery. […] In severe cases, permanent muscle or nerve damage can occur due to compression or loss of blood flow to the lower leg.

• #18 Popliteal Artery Entrapment Syndrome | Frankel Cardiovascular Center | Michigan Medicine

  https://www.umcvc.org/conditions-treatments/popliteal-artery-entrapment-syndrome

  Popliteal artery entrapment syndrome (PAES) is a rare vascular condition that affects the legs. It occurs when the popliteal artery the dominant source of blood supply to the leg below the knee becomes compressed by a muscle, tendon or band behind the knee. This compression restricts blood flow to the lower leg and can cause damage to the artery over time. […] PAES affects individuals under the age of 55, but is more commonly diagnosed in younger, highly active athletes whose calf muscles become enlarged due to exercise and training. Men are two times more likely than women to have the condition.

• #19 Popliteal artery entrapment syndrome: What to know

  https://www.medicalnewstoday.com/articles/popliteal-artery-entrapment-syndrome

  Some people may find that regular participation in sports can lead to PAES developing over time. […] As the calf muscles grow, they can develop bands of scar-like tissue that can start to increase pressure on the artery. […] PAES occurs due to increased pressure from the calf muscles on a blood vessel that supplies the lower leg. Congenital PAES is due to changes during fetal development. Functional PAES develops over time with regular participation in sports.

• #20 Popliteal artery entrapment syndrome – Bradshaw – Cardiovascular Diagnosis and Therapy

  https://cdt.amegroups.org/article/view/46396/html

  The anatomic variant causes of PAES tend to occur in middle-aged men with lower functional demands, while functional PAES presents in younger, highly conditioned athletes, such as cyclists or military personnel. […] The most common symptoms are intermittent claudication and pain in the feet and calves after exercise. […] Surgical decompression is crucial to relieve the aberrant anatomic causes of arterial compression. […] Surgical management of PAES is twofold: decompression of the offending musculotendinous structures and repair of vascular injury.

• #21 Popliteal Artery Entrapment Syndrome (PAES): Symptoms and Treatment

  https://my.clevelandclinic.org/health/diseases/17375-popliteal-artery-entrapment-syndrome-paes

  Popliteal artery entrapment syndrome (PAES) is a rare vascular disease that affects the legs of some young athletes. When you have this syndrome, the muscle behind your knee compresses your popliteal artery the main artery that runs from your thigh to your calf. […] The attachment of your gastrocnemius muscle to your thigh bone causes compression. When your gastrocnemius muscle contracts during foot plantar flexion (pushing down), your muscle compresses your artery. […] There are two main types of compression: Anatomic compression and Non-anatomic compression, functional or physiologic compression. […] Anatomic compression happens because a part of your gastrocnemius muscle crosses over or under your artery. A tendinous band of your muscle can damage your artery. […] Non-anatomic compression, functional or physiologic compression occurs when your muscles are all in the normal location, but typically insert higher up your thigh bone or on the inside notch of your thigh bone at the knee. […] This pulls your muscle to the inside with plantar flexion compressing the muscle against your artery. A muscle located underneath your artery (popliteus muscle) acts as another point of compression. Researchers don’t associate physiologic compression with damage to your artery.

• #22 Popliteal artery entrapment syndrome: What to know

  https://www.medicalnewstoday.com/articles/popliteal-artery-entrapment-syndrome

  Some people may find that regular participation in sports can lead to PAES developing over time. […] As the calf muscles grow, they can develop bands of scar-like tissue that can start to increase pressure on the artery. […] PAES occurs due to increased pressure from the calf muscles on a blood vessel that supplies the lower leg. Congenital PAES is due to changes during fetal development. Functional PAES develops over time with regular participation in sports.

• #23 Popliteal artery entrapment syndrome | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/popliteal-artery-entrapment-syndrome?lang=us

  Popliteal artery entrapment syndrome refers to symptomatic compression or occlusion of the popliteal artery due to a developmentally abnormal positioning of the popliteal artery in relation to its surrounding structures such as with the medial head of gastrocnemius or less commonly with popliteus or fibrous bands. […] The anatomic anomalies may be seen in up to 3-3.5% of the population and are often bilateral 2 (~2/3 of cases). […] Individuals with well-developed muscles are more likely to be symptomatic, which probably explains why the syndrome is most often found in young sportspersons (~60 % in those 30 years) with a male-to-female ratio of 15:1 3. […] Arterial compression can result in chronic vascular microtrauma, local premature arteriosclerosis, and thrombus formation. […] This can result in distal ischemia.

• #24

  https://link.springer.com/article/10.2165/00007256-199928010-00006

  Popliteal artery entrapment syndrome (PAES) is a rare cause of exercise-induced leg pain. Entrapment occurs because of an abnormal relationship between the popliteal artery and the surrounding myofascial structures in the popliteal fossa. […] The aetiology of PAES has an embryological basis related to the development of the popliteal artery and the surrounding musculature. […] Repeated popliteal artery compression causes trauma to the arterial wall, leading to premature localised atherosclerosis. […] The pathology of PAES is believed to be progressive, with arterial thrombosis occurring in some individuals as a natural progression of the disease process. […] Acute ischaemia can occur if there is an occlusion of the artery or thrombosis within an aneurysm.

• #25 Long-Term Results of Surgical Treatment for Popliteal Artery Entrapment Syndrome

  https://www.mdpi.com/2075-4418/14/12/1302

  Nevertheless, most functional PAES are not diagnosed. Nowadays, the diagnosis remains challenging because dynamic imaging is needed as the imaging examinations at rest may be normal. […] PAES may be asymptomatic or may present with intermittent claudication. In rare cases, it can also present with cold feet and the absence of a distal pulse up, with acute limb-threatening ischemia being the most serious and critical manifestation. […] Repetitive trauma to the popliteal artery from focal impingement results in chronic inflammation, followed by occlusive or aneurysmal formation. However, this type is underestimated because only dynamic maneuvers can detect it. Nevertheless, to avoid the disease progression and associated critical complications, surgeons and physicians should not underestimate a clinical suspicion of such pathology.

• #26 A rare cause of intermittent claudication: recurrence of popliteal artery entrapment syndrome in a 16-years-old boy – Turkish Journal of Thoracic and Cardiovascular Surgery

  https://tgkdc.dergisi.org/text.php?lang=en&id=1808

  Popliteal artery entrapment syndrome (PAES) is a rare clinical entity which is predominantly seen in young athletic men. […] Popliteal artery entrapment syndrome (PAES) is an uncommon clinical entity that presents with claudication, and popliteal arterial diseases are rare causes of intermittent claudication. […] Although the exact prevalence of PAES is unknown, there have been reports of its existence in young males 0.16% who were entering military service. […] Popliteal artery disease is a rare cause of IC of the lower leg; however, the most common cause is PAES in young men. […] Other causes of IC are adventitial cystic disease, muscular fibrodysplasia, arteritis, and compression of the artery by exostosis of the distal femur in young athletes. […] Symptomatic PAES if not treated, eventually progresses the luminal narrowing, thrombosis and total occlusion. Because chronic microtrauma of the vessel wall can result in intimal damage and fibrosis that make the vessel susceptible to thrombosis.

• #27 Popliteal artery entrapment syndrome | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/popliteal-artery-entrapment-syndrome?lang=us

  Stenosis and turbulent flow may lead to post-stenotic ectasia or aneurysm formation. […] Five anatomic types of entrapment are typically described 1: type I: popliteal artery has an aberrant medial course around the medial head of the gastrocnemius, type II: artery is not displaced, but the medial head of gastrocnemius inserts more lateral than usual; the artery passes medial and beneath the muscle, type III: an accessory slip of the medial head of gastrocnemius slings around the artery, type IV: artery lies deep in popliteal fossa entrapped by popliteus or fibrous band, type V: both popliteal artery and vein are entrapped. […] Type VI is also described by some of the literature, which is functional and is caused by gastrocnemius muscle hypertrophy 15.

• #28 Frontiers | Case Report: COVID-19 exacerbates acute lower limb ischemia in patients with popliteal artery entrapment syndrome

  https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2024.1329863/full

  Popliteal artery entrapment syndrome (PAES) is a rare clinical ischemic disease of the lower limbs, mainly caused by various reasons such as popliteal artery compression and stenosis and secondary thrombosis caused by an injury of the vascular endothelium due to exercise and other factors. […] As is well known, PAES is mostly caused by long-term compression of the popliteal artery by abnormal anatomical structures, resulting in thickening of the vascular outer membrane and progression of the disease until intimal damage and thrombosis, leading to lower limb ischemia. […] PAES is based on congenital anatomical abnormalities, such as abnormal development of the popliteal fossa structure that compresses the popliteal artery. […] Furthermore, certain factors may lead to the worsening of PAES ischemia. These include blood hypercoagulability and vascular endothelial damage.

• #29 Popliteal Artery Entrapment Syndrome | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/27432

  Furthermore, various anomalies regarding the relative position of the popliteal artery, medial head of the gastrocnemius (MHG) and popliteus muscles define the multiple types of PAES. Also, the aberrant migration of the medial head during embryological development can result in malpositioning of the muscle concerning the nearby vessels. Interestingly, most of the people born with this congenital anomaly mostly remain asymptomatic, suggesting a likely multifactorial process contributing to disease progression. Although this pathology is present from birth, it appears later, likely due to changes related to use of the gastrocnemius muscle in activities such as running or marching causing muscle hypertrophy with external compression and impingement of the popliteal artery by the medial head.

• #30 Popliteal artery entrapment syndrome: What to know

  https://www.medicalnewstoday.com/articles/popliteal-artery-entrapment-syndrome

  Popliteal artery entrapment syndrome (PAES) usually occurs when the head of the gastrocnemius muscle traps or increases pressure on the popliteal artery. The muscle sits at the top of the calf and the back of the knee and is vital for walking. […] Sometimes, PAES may develop due to issues with the plantaris muscle, which supports ankle flexing. […] Congenital PAES might occur due to problems with development before birth. Functional PAES can happen when issues develop over time. […] When a fetus develops, the gastrocnemius and popliteal arteries develop simultaneously. If the gastrocnemius moves into an abnormal position during development, this can trap the artery, leading to PAES. […] This is the most common cause of PAES. People who have PAES from birth do not often show symptoms until they are teenagers or in their 20s.

• #31 Popliteal Artery Entrapment Syndrome | Frankel Cardiovascular Center | Michigan Medicine

  https://www.umcvc.org/conditions-treatments/popliteal-artery-entrapment-syndrome

  Popliteal artery entrapment syndrome (PAES) is a rare vascular condition that affects the legs. It occurs when the popliteal artery the dominant source of blood supply to the leg below the knee becomes compressed by a muscle, tendon or band behind the knee. This compression restricts blood flow to the lower leg and can cause damage to the artery over time. […] PAES affects individuals under the age of 55, but is more commonly diagnosed in younger, highly active athletes whose calf muscles become enlarged due to exercise and training. Men are two times more likely than women to have the condition.

• #32 Long-Term Results of Surgical Treatment for Popliteal Artery Entrapment Syndrome

  https://www.mdpi.com/2075-4418/14/12/1302

  The early formation of the distal portion of the popliteal artery and the delayed migration of the proximal head of the medial gastrocnemius muscle cause the first and second types of compressive mechanisms. […] In the absence of anatomical abnormalities, hypertrophy of the medial and lateral portions of the gastrocnemius muscles intermittently causes compression of the popliteal artery during plantar flexion, resulting in the sixth type of this syndrome, known as the functional subtype. […] The exact incidence of PES is not clear. Clinical studies report an incidence of 0.17%, while post-mortem studies suggest an incidence of 3.5%. In a similar study performed by the Popliteal Vascular Entrapment Forum, an incidence of 4.3% was recorded on 162 limbs. […] Most patients affected by PES are predominantly young (in their early 30 s) males (83%). Hypertrophy of the medial gastrocnemius muscle observed in athletes has been widely linked to functional PAES, with approximately 60% of reported cases affecting young athletes under 30 years.

• #33 What is Popliteal Artery Entrapment Syndrome? – Brisbane Physiotherapy & Podiatry

  https://www.brisbanephysiotherapy.com/news/popliteal-artery-entrapment-syndrome-physiotherapy

  Popliteal artery entrapment syndrome (PAES) is a rare vascular condition characterized by compression or entrapment of the popliteal artery, typically occurring in the popliteal fossa (behind the knee). […] PAES occurs when the muscles, tendons, or other structures in the popliteal fossa compress or exert pressure on the popliteal artery during physical activity. While the exact cause of PAES is not fully understood, several factors may contribute to its development, including: […] Individuals born with anatomical anomalies, such as abnormal muscle or tendon insertions, may be predisposed to PAES. […] Activities that involve repetitive flexion and extension of the knee joint, such as running, cycling, or jumping, can exacerbate the compression of the popliteal artery. […] Enlargement or hypertrophy of the calf muscles, particularly the gastrocnemius muscle, may increase the risk of PAES by exerting excessive pressure on the popliteal artery.

• #34 Popliteal artery entrapment syndrome | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/popliteal-artery-entrapment-syndrome?lang=us

  Popliteal artery entrapment syndrome refers to symptomatic compression or occlusion of the popliteal artery due to a developmentally abnormal positioning of the popliteal artery in relation to its surrounding structures such as with the medial head of gastrocnemius or less commonly with popliteus or fibrous bands. […] The anatomic anomalies may be seen in up to 3-3.5% of the population and are often bilateral 2 (~2/3 of cases). […] Individuals with well-developed muscles are more likely to be symptomatic, which probably explains why the syndrome is most often found in young sportspersons (~60 % in those 30 years) with a male-to-female ratio of 15:1 3. […] Arterial compression can result in chronic vascular microtrauma, local premature arteriosclerosis, and thrombus formation. […] This can result in distal ischemia.

• #35 POPLITEAL ARTERY ENTRAPMENT SYNDROME | Eurorad

  https://eurorad.org/case/4843

  Popliteal artery entrapment syndrome is an important albeit infrequent cause of serious disability among young adults and athletes with anomalous anatomic relationships between the popliteal artery and surrounding musculotendinous structures. […] Most cases occur in younger athletes, possibly because of vigorous training that can lead to functional hypertrophy of the gastrocnemius. The other causes may include a tight or immobile, hypersensitive or spasmodic popliteal artery. […] Repeated popliteal artery compression causes trauma to the arterial wall, leading to premature localized atherosclerosis. […] As the pathology progresses, acute ischemia can occur if there is an occlusion of the artery or thrombosis within an aneurysm. […] Popliteal entrapment is bilateral in 25% to 43% of patients. […] Diagnosing popliteal entrapment can be difficult. […] MRI can distinguish a structural entrapment (caused by an aberrant course of the popliteal artery) from a functional entrapment, but in either case the treatment will be surgical.

• #36 Popliteal Artery Entrapment Syndrome (PAES) Causes and Treatments

  https://www.upmc.com/services/heart-vascular/conditions/popliteal-artery-entrapment-syndrome

  Popliteal artery entrapment syndrome, also called PAES, is a rare vascular disease. […] PAES occurs when nearby tendons and muscles squeeze or compress the popliteal artery. This limits blood flow, leading to symptoms in the lower leg. […] PAES is often a congenital problem, meaning you’re born with the condition. An enlarged calf muscle can also cause PAES to form over time. […] In some cases, compression from PAES can damage and narrow the wall of the popliteal artery. […] In severe cases, permanent muscle or nerve damage can occur due to compression or loss of blood flow to the lower leg.

• #37 Popliteal artery entrapment syndrome – Augusta HealthSearchClose SearchSearch IconSearch IconClose Search IconMobile Menu IconMobile Menu Close IconInstagramFacebookTwitterYoutube

  https://www.augustahealth.com/disease/popliteal-artery-entrapment-syndrome/

  Popliteal artery entrapment syndrome (PAES) is caused by an abnormal calf muscle, usually the gastrocnemius muscle. […] The condition may occur from birth (congenital) or develop later in life (acquired). In the congenital form, the calf muscle or nearby artery is abnormally positioned while the baby grows in the mother’s womb. People with the acquired form of PAES have a calf muscle that is bigger than normal (enlarged). […] The abnormal calf muscle presses on the main artery behind the knee (popliteal artery), reducing blood flow to the lower leg. The lack of blood flow results in pain and cramping in the back of the lower leg during times of activity.

• #38 Popliteal Artery Entrapment Syndrome (PAES): Symptoms and Treatment

  https://my.clevelandclinic.org/health/diseases/17375-popliteal-artery-entrapment-syndrome-paes

  Popliteal artery entrapment syndrome (PAES) is a rare vascular disease that affects the legs of some young athletes. When you have this syndrome, the muscle behind your knee compresses your popliteal artery the main artery that runs from your thigh to your calf. […] The attachment of your gastrocnemius muscle to your thigh bone causes compression. When your gastrocnemius muscle contracts during foot plantar flexion (pushing down), your muscle compresses your artery. […] There are two main types of compression: Anatomic compression and Non-anatomic compression, functional or physiologic compression. […] Anatomic compression happens because a part of your gastrocnemius muscle crosses over or under your artery. A tendinous band of your muscle can damage your artery. […] Non-anatomic compression, functional or physiologic compression occurs when your muscles are all in the normal location, but typically insert higher up your thigh bone or on the inside notch of your thigh bone at the knee. […] This pulls your muscle to the inside with plantar flexion compressing the muscle against your artery. A muscle located underneath your artery (popliteus muscle) acts as another point of compression. Researchers don’t associate physiologic compression with damage to your artery.

• #39 Popliteal artery entrapment syndrome – Augusta HealthSearchClose SearchSearch IconSearch IconClose Search IconMobile Menu IconMobile Menu Close IconInstagramFacebookTwitterYoutube

  https://www.augustahealth.com/disease/popliteal-artery-entrapment-syndrome/

  Popliteal artery entrapment syndrome (PAES) is caused by an abnormal calf muscle, usually the gastrocnemius muscle. […] The condition may occur from birth (congenital) or develop later in life (acquired). In the congenital form, the calf muscle or nearby artery is abnormally positioned while the baby grows in the mother’s womb. People with the acquired form of PAES have a calf muscle that is bigger than normal (enlarged). […] The abnormal calf muscle presses on the main artery behind the knee (popliteal artery), reducing blood flow to the lower leg. The lack of blood flow results in pain and cramping in the back of the lower leg during times of activity.

• #40

  https://link.springer.com/article/10.2165/00007256-199928010-00006

  Popliteal artery entrapment syndrome (PAES) is a rare cause of exercise-induced leg pain. Entrapment occurs because of an abnormal relationship between the popliteal artery and the surrounding myofascial structures in the popliteal fossa. […] The aetiology of PAES has an embryological basis related to the development of the popliteal artery and the surrounding musculature. […] Repeated popliteal artery compression causes trauma to the arterial wall, leading to premature localised atherosclerosis. […] The pathology of PAES is believed to be progressive, with arterial thrombosis occurring in some individuals as a natural progression of the disease process. […] Acute ischaemia can occur if there is an occlusion of the artery or thrombosis within an aneurysm.

• #41 Frontiers | Case Report: COVID-19 exacerbates acute lower limb ischemia in patients with popliteal artery entrapment syndrome

  https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2024.1329863/full

  Popliteal artery entrapment syndrome (PAES) is a rare clinical ischemic disease of the lower limbs, mainly caused by various reasons such as popliteal artery compression and stenosis and secondary thrombosis caused by an injury of the vascular endothelium due to exercise and other factors. […] As is well known, PAES is mostly caused by long-term compression of the popliteal artery by abnormal anatomical structures, resulting in thickening of the vascular outer membrane and progression of the disease until intimal damage and thrombosis, leading to lower limb ischemia. […] PAES is based on congenital anatomical abnormalities, such as abnormal development of the popliteal fossa structure that compresses the popliteal artery. […] Furthermore, certain factors may lead to the worsening of PAES ischemia. These include blood hypercoagulability and vascular endothelial damage.

• #42 Frontiers | Case Report: COVID-19 exacerbates acute lower limb ischemia in patients with popliteal artery entrapment syndrome

  https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2024.1329863/full

  COVID-19 causes endothelial cell damage, exposes collagen, causes coagulation activation, and then induces thrombosis. […] Therefore, combined with the patient’s clinical history and related studies on confirmed thrombosis caused by COVID-19, we can infer that COVID-19 could accelerate the occurrence of PAES.

• #43 Popliteal Artery Entrapment Syndrome | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/27432

  Furthermore, various anomalies regarding the relative position of the popliteal artery, medial head of the gastrocnemius (MHG) and popliteus muscles define the multiple types of PAES. Also, the aberrant migration of the medial head during embryological development can result in malpositioning of the muscle concerning the nearby vessels. Interestingly, most of the people born with this congenital anomaly mostly remain asymptomatic, suggesting a likely multifactorial process contributing to disease progression. Although this pathology is present from birth, it appears later, likely due to changes related to use of the gastrocnemius muscle in activities such as running or marching causing muscle hypertrophy with external compression and impingement of the popliteal artery by the medial head.

• #44 Long-Term Results of Surgical Treatment for Popliteal Artery Entrapment Syndrome

  https://www.mdpi.com/2075-4418/14/12/1302

  The early formation of the distal portion of the popliteal artery and the delayed migration of the proximal head of the medial gastrocnemius muscle cause the first and second types of compressive mechanisms. […] In the absence of anatomical abnormalities, hypertrophy of the medial and lateral portions of the gastrocnemius muscles intermittently causes compression of the popliteal artery during plantar flexion, resulting in the sixth type of this syndrome, known as the functional subtype. […] The exact incidence of PES is not clear. Clinical studies report an incidence of 0.17%, while post-mortem studies suggest an incidence of 3.5%. In a similar study performed by the Popliteal Vascular Entrapment Forum, an incidence of 4.3% was recorded on 162 limbs. […] Most patients affected by PES are predominantly young (in their early 30 s) males (83%). Hypertrophy of the medial gastrocnemius muscle observed in athletes has been widely linked to functional PAES, with approximately 60% of reported cases affecting young athletes under 30 years.

• #45 A rare cause of intermittent claudication: recurrence of popliteal artery entrapment syndrome in a 16-years-old boy – Turkish Journal of Thoracic and Cardiovascular Surgery

  https://tgkdc.dergisi.org/text.php?lang=en&id=1808

  Popliteal artery entrapment syndrome (PAES) is a rare clinical entity which is predominantly seen in young athletic men. […] Popliteal artery entrapment syndrome (PAES) is an uncommon clinical entity that presents with claudication, and popliteal arterial diseases are rare causes of intermittent claudication. […] Although the exact prevalence of PAES is unknown, there have been reports of its existence in young males 0.16% who were entering military service. […] Popliteal artery disease is a rare cause of IC of the lower leg; however, the most common cause is PAES in young men. […] Other causes of IC are adventitial cystic disease, muscular fibrodysplasia, arteritis, and compression of the artery by exostosis of the distal femur in young athletes. […] Symptomatic PAES if not treated, eventually progresses the luminal narrowing, thrombosis and total occlusion. Because chronic microtrauma of the vessel wall can result in intimal damage and fibrosis that make the vessel susceptible to thrombosis.

• #46

  https://www.ijcrimedicine.com/archive/2018-articles/2018100046Z09JM-mathew/100046Z09JM-full-text.php

  In anatomic PAES, often seen in sedentary males in the fifth decade of life, is due to anomalous anatomy of either the gastrocnemius, popliteal artery, or both. […] If the condition is not caused by an anatomic abnormality, then the patient is thought to have functional PAES, which is considered the sixth type. […] The functional type of the popliteal vessel compression was first described by Rignault and colleagues in 1985 where compression of the popliteal artery may be due to an anatomically normal but hypertrophic muscle. […] The condition should be suspected in patients presenting with unexplained leg pain after or during exercise in which other more common diagnoses have been ruled out. […] The prognosis of surgically-corrected PAES is often favorable if the diagnosis is made early.

• #47 Type 2 popliteal artery entrapment syndrome: a case report – Turkish Journal of Thoracic and Cardiovascular Surgery

  https://tgkdc.dergisi.org/text.php?lang=en&id=1681

  Because it is a rare cause of lower extremity claudication, diagnosis of PAES has a high rate of suspicion. The differential diagnosis involves the adventitial cystic disease of the popliteal artery, thromboangiitis obliterans, and compression of the superficial femoral artery at the level of the adductor canal. As in our case, young patients without any risk factors for atherosclerotic disease and without any known vasculitic disease who present with lower extremity claudication should be suspected of having PAES. The definitive diagnostic tool for this syndrome is an MRI. […] Poplitial artery entrapment syndrome usually progresses along with vascular disease until final vessel occlusion with a subsequent ischemic limb event. Therefore, all anatomic entrapments of the popliteal artery should be repaired surgically independent of the symptoms it causes. In our case, the patient already had thrombotic stenosis of the superficial femoral artery which had been treated by stent implantation and angioplasty. Once the diagnosis was confirmed, we continued the management via surgical repair of the entrapment although the patient had virtually no symptoms after the stent implantation.

• #48 Popliteal Artery Entrapment Syndrome: A Case with Bilateral Different Types

  https://www.jchestsurg.org/journal/view.html?doi=10.5090/kjtcs.2014.47.3.302

  Symptomatic PAES needs surgical intervention. Treatment should include decompression of the artery via myotomy, or resection of the fibrous tendon and revascularization of the impaired artery. […] More than 90% of treated patients enjoy a good prognosis, resume normal activities, and exhibit no symptoms. […] In conclusion, PAES is rare, but it may affect young physically active persons and worsen their quality of life. If this disease is suspected, diagnostic evaluation must be performed. The possibility of bilateral PAES cannot be ignored.

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