Materiały źródłowe

• #1 Popliteal Artery Entrapment Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK441965/

  Popliteal artery entrapment syndrome (PAES), described by Stuart in 1879, is an uncommon limb-threatening vascular entity comprising approximately 0.17%-3.5% of the general population in the United States (US). This embryologically developmental anomaly results mainly due to an aberrant relationship of the popliteal artery with the surrounding popliteal fossa myofascial structures. […] 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.

• #2 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. […] Analysis of human embryological development has shown that the popliteal artery and the medial head of the gastrocnemius muscle arise at approximately the same time. Because of that, abnormal development of muscle’s position in relation to the nearby vessels can result in potential vascular compromise. […] 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.

• #3 Popliteal artery entrapment syndrome | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/popliteal-artery-entrapment-syndrome?content_id=CON-20459610

  Popliteal artery entrapment syndrome (PAES) is caused by an irregular calf muscle, usually the gastrocnemius muscle. […] 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.

• #4 Case report and literature review of popliteal artery entrapment syndr | IJGM

  https://www.dovepress.com/case-report-and-literature-review-of-popliteal-artery-entrapment-syndr-peer-reviewed-fulltext-article-IJGM

  Popliteal artery entrapment syndrome (PAES) is an uncommon condition resulting from an abnormal anatomic relationship between the popliteal artery and the surrounding musculature. The compression created by this variance in anatomy can lead to ischemia and vascular claudication. […] Popliteal artery entrapment syndrome (PAES) is an important but infrequent condition that occurs as a result of compression of the popliteal artery by adjacent muscles and tendons, often resulting in ischemia and vascular claudication. […] This abnormal anatomy creates extrinsic compression which can over time cause vascular compression that can lead to damage. Symptoms often occur as a result of arterial wall degeneration and compression, depending on the degree of compression, magnitude of forces acting on the popliteal artery, and duration of compression.

• #5 Popliteal artery entrapment syndrome – PubMed

  https://pubmed.ncbi.nlm.nih.gov/10461713/

  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. Many different classification schemes have been developed to differentiate the various types of abnormal anatomy that are associated with the syndrome. 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.

• #6 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. […] Analysis of human embryological development has shown that the popliteal artery and the medial head of the gastrocnemius muscle arise at approximately the same time. Because of that, abnormal development of muscle’s position in relation to the nearby vessels can result in potential vascular compromise. […] 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.

• #7 Popliteal Artery Entrapment Syndrome – MD Searchlight

  https://mdsearchlight.com/health/popliteal-artery-entrapment-syndrome/

  Popliteal artery entrapment syndrome (PAES) develops from both inborn (congenital) and acquired factors. Our understanding of how humans develop before birth (embryology) has helped us figure out why some people are born with PAES. Specifically, the popliteal artery the blood vessel behind your knee and one part of your calf muscle (medial head of the gastrocnemius) form around the same time. This artery forms from two other arteries, the femoral and sciatic arteries. Later in development, the sciatic artery becomes less prominent, and the femoral artery takes over most of the work of building the popliteal artery. […] The development of another muscle in your calf, the plantaris muscle, can also play a role in whether a person is born with PAES. This muscle, which helps point your toes down (plantar flexion), doesn’t do much on its own, and usually works along with the gastrocnemius. However, the way this muscle forms during early development can be unusual in about 10% of cases. If it does develop oddly, it can essentially capture the popliteal artery, leading to symptoms like cramps when walking.

• #8 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. […] Analysis of human embryological development has shown that the popliteal artery and the medial head of the gastrocnemius muscle arise at approximately the same time. Because of that, abnormal development of muscle’s position in relation to the nearby vessels can result in potential vascular compromise. […] 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.

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

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

  Popliteal artery entrapment syndrome (PAES) is a rare disease of the lower limbs, mainly affecting young patients, due to extrinsic compression of the neurovascular bundle at the popliteal fossa. […] The pathogenic process has an embryological basis related to the development of the popliteal artery and the surrounding musculature. […] 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.

• #10 Popliteal Artery Entrapment Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK441965/

  Popliteal artery entrapment syndrome (PAES), described by Stuart in 1879, is an uncommon limb-threatening vascular entity comprising approximately 0.17%-3.5% of the general population in the United States (US). This embryologically developmental anomaly results mainly due to an aberrant relationship of the popliteal artery with the surrounding popliteal fossa myofascial structures. […] 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.

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

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

  Popliteal artery entrapment syndrome (PAES), described by Stuart in 1879, is an uncommon limb-threatening vascular entity comprising approximately 0.17%-3.5% of the general population in the United States (US). This embryologically developmental anomaly results mainly due to an aberrant relationship of the popliteal artery with the surrounding popliteal fossa myofascial structures. […] 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. […] The embryological phases of the plantaris muscles play a significant contribution to the congenital PAES.

• #12 Popliteal Artery Entrapment Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK441965/

  Popliteal artery entrapment syndrome (PAES), described by Stuart in 1879, is an uncommon limb-threatening vascular entity comprising approximately 0.17%-3.5% of the general population in the United States (US). This embryologically developmental anomaly results mainly due to an aberrant relationship of the popliteal artery with the surrounding popliteal fossa myofascial structures. […] 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.

• #13 Popliteal Artery Entrapment Syndrome – MD Searchlight

  https://mdsearchlight.com/health/popliteal-artery-entrapment-syndrome/

  Popliteal artery entrapment syndrome (PAES) develops from both inborn (congenital) and acquired factors. Our understanding of how humans develop before birth (embryology) has helped us figure out why some people are born with PAES. Specifically, the popliteal artery the blood vessel behind your knee and one part of your calf muscle (medial head of the gastrocnemius) form around the same time. This artery forms from two other arteries, the femoral and sciatic arteries. Later in development, the sciatic artery becomes less prominent, and the femoral artery takes over most of the work of building the popliteal artery. […] The development of another muscle in your calf, the plantaris muscle, can also play a role in whether a person is born with PAES. This muscle, which helps point your toes down (plantar flexion), doesn’t do much on its own, and usually works along with the gastrocnemius. However, the way this muscle forms during early development can be unusual in about 10% of cases. If it does develop oddly, it can essentially capture the popliteal artery, leading to symptoms like cramps when walking.

• #14 Popliteal Artery Entrapment Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK441965/

  Generally, the majority of the PAES cases are due to the embryological anomalies while fewer patients have been documented having acquired (fibrous bands) causes for the PAES. Additionally, the PAES are further classified into six different types based on the relationship of the medial head of the gastrocnemius muscle with the popliteal artery. […] The functional PAES (Type VI or F) describes another subtype of the disease that is not due to inherited anatomic abnormalities. It has been postulated that repeated microtrauma results in the growth of connective tissue, destruction of the internal elastic lamina, and damage to the smooth muscles resulting in fibrosis and scar formation. The resulting injury leads to the thrombosis, embolization, and aneurysmal degeneration.

• #15 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. […] Generally, the majority of the PAES cases are due to the embryological anomalies while fewer patients have been documented having acquired (fibrous bands) causes for the PAES. Additionally, the PAES are further classified into six different types based on the relationship of the medial head of the gastrocnemius muscle with the popliteal artery. […] The functional PAES (Type VI or F) describes another subtype of the disease that is not due to inherited anatomic abnormalities. It has been postulated that repeated microtrauma results in the growth of connective tissue, destruction of the internal elastic lamina, and damage to the smooth muscles resulting in fibrosis and scar formation.

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

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

  Popliteal artery entrapment syndrome (PAES) is an uncommon cause of lower extremity exertional claudication due to external compression of vascular structures in the popliteal fossa. A developmental anomaly due to an aberrant relationship of the artery with the surrounding myofascial structures contributes to the vascular compromise. […] PAES is a rare vascular disorder defined as compression of the popliteal artery by aberrant myotendinous structures in the popliteal fossa. Anatomic PAES results from abnormal embryological development of the popliteal artery, gastrocnemius muscle, or other myofascial structures within the popliteal fossa. […] The syndrome exists in six forms, divided into two categories: anatomic/congenital and functional. […] Early in the clinical course, the artery is patent except during muscle contraction. The ensuing ischemic symptoms are sudden in onset during exercise but completely resolve with rest. However, progressive popliteal artery injury can occur leading to luminal narrowing and occasionally occlusion, median prevalence 24%.

• #17 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. […] The pathogenesis, clinical features, diagnosis, and treatment of PES are reviewed. […] Congenital popliteal entrapment (types I to VI (see 'Anatomic types’ below)) 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.

• #18 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. […] Arterial compression can result in chronic vascular microtrauma, local premature arteriosclerosis, and thrombus formation. This can result in distal ischemia. Stenosis and turbulent flow may lead to post-stenotic ectasia or aneurysm formation. […] Five anatomic types of entrapment are typically described: 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.

• #19 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

  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.

• #20 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. […] Arterial compression can result in chronic vascular microtrauma, local premature arteriosclerosis, and thrombus formation. This can result in distal ischemia. Stenosis and turbulent flow may lead to post-stenotic ectasia or aneurysm formation. […] Five anatomic types of entrapment are typically described: 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.

• #21 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

  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.

• #22 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. […] Arterial compression can result in chronic vascular microtrauma, local premature arteriosclerosis, and thrombus formation. This can result in distal ischemia. Stenosis and turbulent flow may lead to post-stenotic ectasia or aneurysm formation. […] Five anatomic types of entrapment are typically described: 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.

• #23 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

  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.

• #24 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. […] Arterial compression can result in chronic vascular microtrauma, local premature arteriosclerosis, and thrombus formation. This can result in distal ischemia. Stenosis and turbulent flow may lead to post-stenotic ectasia or aneurysm formation. […] Five anatomic types of entrapment are typically described: 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.

• #25 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

  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.

• #26 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. […] Arterial compression can result in chronic vascular microtrauma, local premature arteriosclerosis, and thrombus formation. This can result in distal ischemia. Stenosis and turbulent flow may lead to post-stenotic ectasia or aneurysm formation. […] Five anatomic types of entrapment are typically described: 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.

• #27 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

  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.

• #28 Popliteal Artery Entrapment Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK441965/

  Generally, the majority of the PAES cases are due to the embryological anomalies while fewer patients have been documented having acquired (fibrous bands) causes for the PAES. Additionally, the PAES are further classified into six different types based on the relationship of the medial head of the gastrocnemius muscle with the popliteal artery. […] The functional PAES (Type VI or F) describes another subtype of the disease that is not due to inherited anatomic abnormalities. It has been postulated that repeated microtrauma results in the growth of connective tissue, destruction of the internal elastic lamina, and damage to the smooth muscles resulting in fibrosis and scar formation. The resulting injury leads to the thrombosis, embolization, and aneurysmal degeneration.

• #29 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. […] Analysis of human embryological development has shown that the popliteal artery and the medial head of the gastrocnemius muscle arise at approximately the same time. Because of that, abnormal development of muscle’s position in relation to the nearby vessels can result in potential vascular compromise. […] 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.

• #30 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

  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.

• #31 Sports Injury Bulletin – Anatomy – Popliteal artery entrapment: a mysterious syndrome

  https://www.sportsinjurybulletin.com/anatomy/popliteal-artery-entrapment-a-mysterious-syndrome

  Popliteal artery entrapment syndrome (PAES) occurs when muscles that surround the popliteal artery in the area of the popliteal fossa, occlude the artery (and sometimes the vein as well), and decrease blood flow to the lower leg. […] In anatomical PAES, the abnormal positions of the artery, or the muscles that surround the artery, cause compression against the bone or another muscle. […] Functional PAES occurs despite normal anatomy, and possibly due to compartment pressure or hypertrophy of the neighbouring muscles. […] The relationship of the popliteal artery to the surrounding musculature causes compression in certain positions or when the muscles are activated. […] Doppler ultrasound studies show that in subjects with popliteal artery compression, anywhere from 7% to 80% of this group are asymptomatic.

• #32 Popliteal Artery Entrapment Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK441965/

  Generally, the majority of the PAES cases are due to the embryological anomalies while fewer patients have been documented having acquired (fibrous bands) causes for the PAES. Additionally, the PAES are further classified into six different types based on the relationship of the medial head of the gastrocnemius muscle with the popliteal artery. […] The functional PAES (Type VI or F) describes another subtype of the disease that is not due to inherited anatomic abnormalities. It has been postulated that repeated microtrauma results in the growth of connective tissue, destruction of the internal elastic lamina, and damage to the smooth muscles resulting in fibrosis and scar formation. The resulting injury leads to the thrombosis, embolization, and aneurysmal degeneration.

• #33 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. […] Generally, the majority of the PAES cases are due to the embryological anomalies while fewer patients have been documented having acquired (fibrous bands) causes for the PAES. Additionally, the PAES are further classified into six different types based on the relationship of the medial head of the gastrocnemius muscle with the popliteal artery. […] The functional PAES (Type VI or F) describes another subtype of the disease that is not due to inherited anatomic abnormalities. It has been postulated that repeated microtrauma results in the growth of connective tissue, destruction of the internal elastic lamina, and damage to the smooth muscles resulting in fibrosis and scar formation.

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

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

  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. This leads to an ulcer or sore in your artery, buildup of a clot, and eventual occlusion (closing or blocking) of your artery or downstream arteries. […] 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.

• #35 Popliteal Artery Entrapment Syndrome (PAES) — The Physio Lab

  http://www.thephysiolab.com/news/2025/3/7/popliteal-artery-entrapment-syndrome-paes

  Popliteal Artery Entrapment Syndrome (PAES) is a rare vascular condition that occurs when the popliteal artery, the major blood vessel behind the knee, is compressed or trapped by the surrounding muscles or structures. This condition can lead to various symptoms, including leg pain, muscle weakness, and, in more severe cases, arterial occlusion, which can affect circulation in the lower leg. […] In PAES, the popliteal artery is subjected to compression by muscles, tendons, or other anatomical structures, leading to restricted blood flow. […] The popliteal artery is compressed by the medial head of the gastrocnemius muscle. […] The artery is compressed by fibrous bands. […] A combination of both muscular and fibrous compression causes arterial compression. […] While this condition is often present at birth due to an abnormal anatomical structure, it is more commonly seen in athletes or individuals who engage in repetitive, intense physical activities such as running or cycling. The compression of the artery is often worsened by physical exertion, which increases the demand for blood in the legs. […] The goal of surgical treatment is to restore normal blood flow to the affected leg, reduce occlusion and prevent further damage to the artery.

• #36 Popliteal Artery Entrapment Syndrome (PAES) — The Physio Lab

  http://www.thephysiolab.com/news/2025/3/7/popliteal-artery-entrapment-syndrome-paes

  Popliteal Artery Entrapment Syndrome (PAES) is a rare vascular condition that occurs when the popliteal artery, the major blood vessel behind the knee, is compressed or trapped by the surrounding muscles or structures. This condition can lead to various symptoms, including leg pain, muscle weakness, and, in more severe cases, arterial occlusion, which can affect circulation in the lower leg. […] In PAES, the popliteal artery is subjected to compression by muscles, tendons, or other anatomical structures, leading to restricted blood flow. […] The popliteal artery is compressed by the medial head of the gastrocnemius muscle. […] The artery is compressed by fibrous bands. […] A combination of both muscular and fibrous compression causes arterial compression. […] While this condition is often present at birth due to an abnormal anatomical structure, it is more commonly seen in athletes or individuals who engage in repetitive, intense physical activities such as running or cycling. The compression of the artery is often worsened by physical exertion, which increases the demand for blood in the legs. […] The goal of surgical treatment is to restore normal blood flow to the affected leg, reduce occlusion and prevent further damage to the artery.

• #37 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. […] During exercise, repetitive compression leads to spasms of your artery. This reduces blood flow. The reduced blood flow leads to a buildup of lactic acid and carbon dioxide in your muscles and nerves, which produces heaviness, achiness, tiredness and sometimes numbness in your calf and foot. […] There are two main types of compression: Anatomic compression and Non-anatomic compression, functional or physiologic compression.

• #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. […] During exercise, repetitive compression leads to spasms of your artery. This reduces blood flow. The reduced blood flow leads to a buildup of lactic acid and carbon dioxide in your muscles and nerves, which produces heaviness, achiness, tiredness and sometimes numbness in your calf and foot. […] There are two main types of compression: Anatomic compression and Non-anatomic compression, functional or physiologic compression.

• #39 Popliteal artery entrapment syndrome – PubMed

  https://pubmed.ncbi.nlm.nih.gov/10461713/

  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. Many different classification schemes have been developed to differentiate the various types of abnormal anatomy that are associated with the syndrome. 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.

• #40 Popliteal artery entrapment syndrome – PubMed

  https://pubmed.ncbi.nlm.nih.gov/10461713/

  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. Many different classification schemes have been developed to differentiate the various types of abnormal anatomy that are associated with the syndrome. 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.

• #41 Circulation Clinic | Popliteal entrapment syndrome

  https://www.circulationclinic.com/popliteal-entrapment-syndrome

  Popliteal artery entrapment syndrome (PAES) is caused by an anomalous arrangement of muscles and/or tendons behind the knee that causes compression of the popliteal artery the main artery that runs behind the knee. […] PAES results from abnormal anatomy behind the knee joint and treatment is based around surgically restoring normal anatomy in order to relieve compression of the popliteal artery. […] Depending on the extent of the muscle anomaly, your surgeon may elect to simply divide the muscle band or, for more extensive disease, re-implant the abnormal muscle into the anatomically correct location. […] Repeated compression of the popliteal artery may damage the artery with the development of a permanent stricture or blockage.

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

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

  Popliteal artery entrapment syndrome (PAES) is an uncommon cause of lower extremity exertional claudication due to external compression of vascular structures in the popliteal fossa. A developmental anomaly due to an aberrant relationship of the artery with the surrounding myofascial structures contributes to the vascular compromise. […] PAES is a rare vascular disorder defined as compression of the popliteal artery by aberrant myotendinous structures in the popliteal fossa. Anatomic PAES results from abnormal embryological development of the popliteal artery, gastrocnemius muscle, or other myofascial structures within the popliteal fossa. […] The syndrome exists in six forms, divided into two categories: anatomic/congenital and functional. […] Early in the clinical course, the artery is patent except during muscle contraction. The ensuing ischemic symptoms are sudden in onset during exercise but completely resolve with rest. However, progressive popliteal artery injury can occur leading to luminal narrowing and occasionally occlusion, median prevalence 24%.

• #43 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. […] Arterial compression can result in chronic vascular microtrauma, local premature arteriosclerosis, and thrombus formation. This can result in distal ischemia. Stenosis and turbulent flow may lead to post-stenotic ectasia or aneurysm formation. […] Five anatomic types of entrapment are typically described: 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.

• #44 Popliteal Artery Entrapment Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK441965/

  Generally, the majority of the PAES cases are due to the embryological anomalies while fewer patients have been documented having acquired (fibrous bands) causes for the PAES. Additionally, the PAES are further classified into six different types based on the relationship of the medial head of the gastrocnemius muscle with the popliteal artery. […] The functional PAES (Type VI or F) describes another subtype of the disease that is not due to inherited anatomic abnormalities. It has been postulated that repeated microtrauma results in the growth of connective tissue, destruction of the internal elastic lamina, and damage to the smooth muscles resulting in fibrosis and scar formation. The resulting injury leads to the thrombosis, embolization, and aneurysmal degeneration.

• #45 Popliteal Artery Entrapment Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK441965/

  Generally, the majority of the PAES cases are due to the embryological anomalies while fewer patients have been documented having acquired (fibrous bands) causes for the PAES. Additionally, the PAES are further classified into six different types based on the relationship of the medial head of the gastrocnemius muscle with the popliteal artery. […] The functional PAES (Type VI or F) describes another subtype of the disease that is not due to inherited anatomic abnormalities. It has been postulated that repeated microtrauma results in the growth of connective tissue, destruction of the internal elastic lamina, and damage to the smooth muscles resulting in fibrosis and scar formation. The resulting injury leads to the thrombosis, embolization, and aneurysmal degeneration.

• #46 Popliteal artery entrapment syndrome

  https://www.visualdx.com/visualdx/diagnosis/?moduleId=101&diagnosisId=56770

  Causes / typical injury mechanism: Most often, popliteal artery entrapment syndrome (PAES) is a congenital abnormality of the gastrocnemius, popliteus, or the popliteal artery vasculature structure or position that, through repetitive overuse, leads to chronic pressure, ischemia, and a gradual thickening of the popliteal artery. […] Pathophysiology: The long-term compression of the popliteal artery leads to the thickening of the artery and complications such as ischemia, stenosis, thromboembolization, occlusion, and aneurysm formation.

• #47 Case report and literature review of popliteal artery entrapment syndr | IJGM

  https://www.dovepress.com/case-report-and-literature-review-of-popliteal-artery-entrapment-syndr-peer-reviewed-fulltext-article-IJGM

  If untreated, the compression mechanism frequently results in deterioration of the popliteal artery which may progress to an occlusion. Recurrent popliteal artery compression can cause intimal damage, thrombosis, distal embolization, post-stenotic dilation, and formation of true aneurysm, which makes accurate diagnosis and timely management imperative. […] The most common presentation is intermittent claudication in young or middle-aged athletic patients without any context of atherosclerosis. […] Once the diagnosis of PAES has been made, several treatment options are available, with the treatment objective being to release the popliteal artery from compression and preserve popliteal arterial flow. Conventional surgery, endovascular surgery, thrombolysis, or a combination of these modalities are all reasonable treatment options depending on the patients clinical symptomology and anatomy.

• #48

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

  Movements that may exacerbate symptoms include repetitive leg extension and plantar flexion. This repetitive trauma of the popliteal artery may result in arterial injury, atherosclerosis, arterial aneurysm, and thrombus formation. […] The diagnosis of popliteal artery entrapment early in its course is crucial and relies upon disease awareness and suspicion based on the history and physical examination. Noninvasive and sometimes invasive tests are needed to demonstrate both the anatomic and functional aspects of the disease. Tests including arterial duplex or angiography with provocative maneuver scan show the functional result of compression. CT or magnetic resonance imaging may demonstrate the anatomic variant causing the compression. […] The treatment of PAES is based on the type of entrapment and degree of arterial pathology. It can range from simple myotomy of the medial head of the gastrocnemius to vascular repair or grafting if arterial damage is present, to endarterectomy in the presence of a thrombus.

• #49

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

  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. During development, the neurovascular bundle and developing muscle groups are maturing in the popliteal fossa in a dynamic manner. Any disruption of the migration pattern or timing of development can result in abnormal anatomy.

• #50 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 anatomical anomalies, overuse or repetitive movements, and muscular hypertrophy. […] 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.

• #51 Concurrent Chronic Exertional Compartment Syndrome and Popliteal Artery Entrapment Syndrome

  https://www.mdpi.com/2075-4418/14/16/1825

  Exertional leg pain occurs with notable frequency among athletes and poses diagnostic challenges to clinicians due to overlapping symptomatology. […] However, her clinical presentation was suspicious for concurrent type VI popliteal artery entrapment syndrome (PAES), prompting further radiographic testing of magnetic resonance angiography (MRA). […] This case underscores the importance for clinicians to be aware that the successful diagnosis of one condition does not exclude the possibility of a secondary, unrelated pathology. […] While concurrent diagnoses are infrequent, their occurrence can present formidable management obstacles. […] The pathophysiology is thought to be reversible, exercise-induced compression within the fascial compartment, causing thickening and scarring of the gastrocnemius and soleal fascia.

• #52 Concurrent Chronic Exertional Compartment Syndrome and Popliteal Artery Entrapment Syndrome

  https://www.mdpi.com/2075-4418/14/16/1825

  These changes inhibit the capacity of the muscles for expansion to accommodate increased arterial flow with exercise, resulting in diminished tissue perfusion and subsequent ischemic pain across any of the four compartments of the lower leg. […] PAES denotes a specific anatomic variation wherein the popliteal artery is compressed by a surrounding myofascial structure with exercise. […] Depending on the course of the popliteal artery and compressing structure, PAES is classified into six different variations. […] While both type IV PAES and CECS result in ischemic pain during exercise, PAES involves the compression of the popliteal artery due to a hypertrophied gastrocnemius muscle, which is a distinct but related pathophysiological mechanism compared to CECS. […] One hypothesis is that the patient’s venous and arterial compression led to the development of exertional venous hypertension and associated muscle edema that presented as exertional leg pain.

• #53 Concurrent Chronic Exertional Compartment Syndrome and Popliteal Artery Entrapment Syndrome

  https://www.mdpi.com/2075-4418/14/16/1825

  These changes inhibit the capacity of the muscles for expansion to accommodate increased arterial flow with exercise, resulting in diminished tissue perfusion and subsequent ischemic pain across any of the four compartments of the lower leg. […] PAES denotes a specific anatomic variation wherein the popliteal artery is compressed by a surrounding myofascial structure with exercise. […] Depending on the course of the popliteal artery and compressing structure, PAES is classified into six different variations. […] While both type IV PAES and CECS result in ischemic pain during exercise, PAES involves the compression of the popliteal artery due to a hypertrophied gastrocnemius muscle, which is a distinct but related pathophysiological mechanism compared to CECS. […] One hypothesis is that the patient’s venous and arterial compression led to the development of exertional venous hypertension and associated muscle edema that presented as exertional leg pain.

• #54 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. […] Interestingly, this case reported that the patient developed intermittent claudication 1 week after COVID-19 infection and had no symptoms before that. […] Generally speaking, the abnormal fibrous band crossing the superficial surface of the popliteal artery in patients is innate. In addition, it is well known that PAES is often caused by long-term compression of the popliteal artery by abnormal anatomical structures, resulting in thickening of the outer membrane of the blood vessels and progression of the disease until intimal damage and thrombosis, leading to lower limb ischemia.

• #55 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

  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. […] The key to treating PAES lies in relieving popliteal artery compression and restoring the blood supply to the affected limb. […] Thus, popliteal artery bypass surgery may be the best treatment for PAES.

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

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

  Surgical management of PAES is twofold: decompression of the offending musculotendinous structures and repair of vascular injury. In anatomic PAES, surgical correction of the aberrant anatomy is always necessary, as the natural history of the syndrome involves vascular injury and occlusion over time.

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

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

  Surgical management of PAES is twofold: decompression of the offending musculotendinous structures and repair of vascular injury. In anatomic PAES, surgical correction of the aberrant anatomy is always necessary, as the natural history of the syndrome involves vascular injury and occlusion over time.

• #58 Circulation Clinic | Popliteal entrapment syndrome

  https://www.circulationclinic.com/popliteal-entrapment-syndrome

  Popliteal artery entrapment syndrome (PAES) is caused by an anomalous arrangement of muscles and/or tendons behind the knee that causes compression of the popliteal artery the main artery that runs behind the knee. […] PAES results from abnormal anatomy behind the knee joint and treatment is based around surgically restoring normal anatomy in order to relieve compression of the popliteal artery. […] Depending on the extent of the muscle anomaly, your surgeon may elect to simply divide the muscle band or, for more extensive disease, re-implant the abnormal muscle into the anatomically correct location. […] Repeated compression of the popliteal artery may damage the artery with the development of a permanent stricture or blockage.

• #59 Case report and literature review of popliteal artery entrapment syndr | IJGM

  https://www.dovepress.com/case-report-and-literature-review-of-popliteal-artery-entrapment-syndr-peer-reviewed-fulltext-article-IJGM

  If the artery is occluded, stenotic, or aneurysmal, vascular reconstruction is mandatory in addition to the division of any entrapping structure. In patients with an acute occlusion, thrombolysis and angioplasty prior to surgery are appropriate, but have a high risk of reocclusion and will not be effective without removing the underlying reason for the popliteal artery entrapment. […] We would recommend considering PAES in young patients with calf claudication. If untreated, the compression caused by this abnormal anatomy frequently results in damage to the popliteal artery which may give rise to an occlusion, making timely diagnosis and management essential.

• #60 Case report and literature review of popliteal artery entrapment syndr | IJGM

  https://www.dovepress.com/case-report-and-literature-review-of-popliteal-artery-entrapment-syndr-peer-reviewed-fulltext-article-IJGM

  If the artery is occluded, stenotic, or aneurysmal, vascular reconstruction is mandatory in addition to the division of any entrapping structure. In patients with an acute occlusion, thrombolysis and angioplasty prior to surgery are appropriate, but have a high risk of reocclusion and will not be effective without removing the underlying reason for the popliteal artery entrapment. […] We would recommend considering PAES in young patients with calf claudication. If untreated, the compression caused by this abnormal anatomy frequently results in damage to the popliteal artery which may give rise to an occlusion, making timely diagnosis and management essential.

• #61 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. […] Your UPMC vascular surgeon can treat PAES through open surgery to release the compression of the popliteal artery. […] PAES surgery successfully relieves symptoms in more than 90 percent of people.

• #62 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

  The symptoms and signs include intermittent claudication, cramping pain, paresthesia, tingling, and coldness in the foot and limb weakness. […] Imaging examinations include Doppler ultrasonography, MRI/magnetic resonance angiography (MRA), computed tomography angiography (CTA), and catheter-based angiography. […] MRI/MRA can also be used to identify other issues, such as trauma and cystic adventitial disease. […] 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. […] However, if there is marked thickening, occlusion or aneurysm formation of the vessel walls, it is necessary to consider vascular bypass or transplantation, and the vessel frequently used for transplantation is the saphenous vein. […] Type 6 of the PAES is functional type. The surgical effect on type 6 is worse than that on the other types, because the anatomy itself is normal.

• #63

  https://link.springer.com/article/10.1007/s12262-024-04065-2

  Popliteal artery entrapment syndrome (PAES), a rare vascular developmental anomaly, occurs due to abnormal relationship between popliteal artery and the myofascial structures in the popliteal fossa. […] The signs and symptoms are related to either stenosis, occlusion, aneurysmal dilatation of popliteal artery or due to distal embolization. […] PAES is classified into six types (type IVI) depending on relationship between popliteal artery and medial head of gastrocnemius around popliteal fossa. […] Diagnosis remains challenging as symptoms mimic other vascular conditions like peripheral arterial occlusive disease (PAOD), thromboangiitis obliterans (TAO), adventitial cystic disease (ACD), fibro-muscular dysplasia (FMD), small- and medium-vessel vasculitis etc. […] PAES with popliteal artery occlusion was suspected clinically, confirmed on imaging and treated successfully by popliteal artery (P1-P3) reverse saphenous vein graft (RSVG) with favorable outcome.

• #64 Concurrent Chronic Exertional Compartment Syndrome and Popliteal Artery Entrapment Syndrome

  https://www.mdpi.com/2075-4418/14/16/1825

  Therefore, it is possible that transient ischemia and reperfusion injury caused by PAES contributed to the additional edema and exacerbated a pre-existing CECS. […] The gold standard diagnostic study is both MRA and angiography, demonstrating popliteal artery impingement. […] Management of PAES often requires surgical exploration and release of the popliteal artery through sectioning of fibrous bands. […] Left untreated, PAES may result in complications such as popliteal artery stenosis, thrombosis, or limb-threatening distal arterial thromboembolism. […] The main treatment strategy for diseases within the external vascular compression category is to remove the external compressor. […] For PAES, surgical outcomes are generally positive: one recent retrospective study reported no complications and a success rate of 100%.

• #65 Popliteal artery entrapment | Eurorad

  https://www.eurorad.org/case/15054

  Popliteal artery entrapment may be entrapped by the related anatomical structures at the popliteal fossa especially the medial head gastrocnemius muscle, popliteus muscle or less commonly anomalous traversing fibrous bands. […] Although the anatomical entrapment is existing in nearly 3% of the population, yet, the symptomatic entrapment occurs in the minority of cases notably those with well-developed muscles which explain why this syndrome is more common in athletic young males. […] The chronic arterial compression will result in intimal hyperplasia and progressive arterial stenosis which may result finally in total gradual permanent arterial occlusion or may result in acute thrombosis with limb-threatening ischaemia. […] Popliteal entrapment syndrome is moreover anatomically classified into five different types according to the mechanism of entrapment.

• #66

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

  Movements that may exacerbate symptoms include repetitive leg extension and plantar flexion. This repetitive trauma of the popliteal artery may result in arterial injury, atherosclerosis, arterial aneurysm, and thrombus formation. […] The diagnosis of popliteal artery entrapment early in its course is crucial and relies upon disease awareness and suspicion based on the history and physical examination. Noninvasive and sometimes invasive tests are needed to demonstrate both the anatomic and functional aspects of the disease. Tests including arterial duplex or angiography with provocative maneuver scan show the functional result of compression. CT or magnetic resonance imaging may demonstrate the anatomic variant causing the compression. […] The treatment of PAES is based on the type of entrapment and degree of arterial pathology. It can range from simple myotomy of the medial head of the gastrocnemius to vascular repair or grafting if arterial damage is present, to endarterectomy in the presence of a thrombus.

• #67 :: astr.or.kr :: Annals of Surgical Treatment and Research

  https://astr.or.kr/DOIx.php?id=10.4174/astr.2018.94.5.262

  Anomalies of the lateral head of the gastrocnemius muscle can play a role in the development of PAES, and Kim classified such anomalies into 2 types—an abnormal insertion type and an aberrant accessory slip type. […] However, when the plantaris muscle develops abnormally, it can entrap the popliteal artery upon contraction, which occurs upon plantar flexion of the ankle. […] Type II anomalies showed a higher incidence of arterial occlusion compared to type III anomalies. […] We propose that direct repair of a popliteal artery lesion followed by myotomy via a posterior approach could have the best chance of achieving graft patency. […] In conclusion, treatment of PAES should be individualized based on pathology, symptoms and imaging studies.

• #68

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

  Movements that may exacerbate symptoms include repetitive leg extension and plantar flexion. This repetitive trauma of the popliteal artery may result in arterial injury, atherosclerosis, arterial aneurysm, and thrombus formation. […] The diagnosis of popliteal artery entrapment early in its course is crucial and relies upon disease awareness and suspicion based on the history and physical examination. Noninvasive and sometimes invasive tests are needed to demonstrate both the anatomic and functional aspects of the disease. Tests including arterial duplex or angiography with provocative maneuver scan show the functional result of compression. CT or magnetic resonance imaging may demonstrate the anatomic variant causing the compression. […] The treatment of PAES is based on the type of entrapment and degree of arterial pathology. It can range from simple myotomy of the medial head of the gastrocnemius to vascular repair or grafting if arterial damage is present, to endarterectomy in the presence of a thrombus.

• #69 Recognising and Managing Popliteal Artery Entrapment Syndrome A Concise Overview for Physiotherapists – BJSM blog – social media’s leading SEM voice

  https://blogs.bmj.com/bjsm/2025/04/07/recognising-and-managing-popliteal-artery-entrapment-syndrome-a-concise-overview-for-physiotherapists/

  Surgery depends on the PAES subtype and symptoms. Early intervention focuses on musculotendinous release, while advanced cases may require arterial bypass. For Anatomical PAES, procedures include myotomy of the medial head of the gastrocnemius, re-routing of the artery, and additional decompression for complex cases. For Functional PAES, options include myotomy, fasciotomy, plantaris muscle excision, and other decompressive techniques. Long-term recurrence in FPAES may result from fibrosis around the neurovascular bundle.

• #70 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

  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. […] The key to treating PAES lies in relieving popliteal artery compression and restoring the blood supply to the affected limb. […] Thus, popliteal artery bypass surgery may be the best treatment for PAES.

• #71 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

  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. […] The key to treating PAES lies in relieving popliteal artery compression and restoring the blood supply to the affected limb. […] Thus, popliteal artery bypass surgery may be the best treatment for PAES.

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