ENTRAPMENT SYNDROME IN A NON-ATHLETIC PATIENT

  • Tony Soares Department of Vascular Surgery, Hospital Santa Maria, Lisbon, Portugal; Lisbon Academic Medical Centre, Lisbon, Portugal
  • José Tiago Department of Vascular Surgery, Hospital Santa Maria, Lisbon, Portugal; Lisbon Academic Medical Centre, Lisbon, Portugal
  • Viviana Manuel Department of Vascular Surgery, Hospital Santa Maria, Lisbon, Portugal; Lisbon Academic Medical Centre, Lisbon, Portugal
  • Carlos Martins Department of Vascular Surgery, Hospital Santa Maria, Lisbon, Portugal; Lisbon Academic Medical Centre, Lisbon, Portugal
  • Pedro Amorim Department of Vascular Surgery, Hospital Santa Maria, Lisbon, Portugal; University of Lisbon, Lisbon, Portugal; Lisbon Academic Medical Centre, Lisbon, Portugal
  • Luís Mendes Pedro Department of Vascular Surgery, Hospital Santa Maria, Lisbon, Portugal; University of Lisbon, Lisbon, Portugal; Lisbon Academic Medical Centre, Lisbon, Portugal
Keywords: Entrapment, PAES, popliteal artery, surgery, diagnosis, treatment

Abstract

The popliteal artery entrapment syndrome (PAES) is a major cause of claudication and acute ischemia of lower limb in young athletes without risk factors for atherosclerosis.

We present a 39 years-old female patient with no relevant past history and no sport activity, admitted to our emergency department with acute disabling claudication in the right lower limb caused by retrogeniculate popliteal artery occlusion. Computed tomography scan confirmed a type II popliteal entrapment syndrome with popliteal artery occlusion. The patient was submitted to surgery that consisted in myotomy of the medial head of the gastrocnemius muscle, division of the anomalous fibrous band, resection of the diseased popliteal artery and interposition of a reverse ipsilateral saphenous vein graft. The patient recovered distal pulse on the right foot.

Previously considered as a rare disease, the growing number of publications about PAES in the medical literature show the opposite. However, little is known about the prevalence of this syndrome and some studies report a prevalence of 0.165–3.5%. PAES is more common in males and in almost 60% is bilateral. The best treatment results are obtained with replacement of the popliteal artery with graft interposition, preferably venous. Currently, this approach is advocated in all patients with entrapment with the exception of early stages with arterial disease confined to the adventitia.

PAES is not as rare as previously admitted and therefore it is important to maintain a high index of suspicion in these age group.

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Published
2018-12-21
Section
Clinical Case

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