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Popliteal Artery Entrapment Syndrome


Presentation

  • This report describes the presentation and surgical management of a case of PAES presenting with limb pain and includes a review of the literature on this condition.[ncbi.nlm.nih.gov]
  • The mean age at the time of presentation was 35.0 years (SD, 11.6 years). Claudication was the most frequent presenting symptom (70 of 88 limbs).[ncbi.nlm.nih.gov]
  • We present an 11.5-year-old girl with thrombosed aneurysm of the right popliteal artery, subsequently diagnosed with bilateral type I PAES. Multimodality illustration of the radiological findings is presented.[ncbi.nlm.nih.gov]
  • Intermittent claudication was the most frequent presenting symptom (seven of eight limbs). All the patients had Delaney's type III PAES.[ncbi.nlm.nih.gov]
  • The mechanism, presentation, imaging findings, and management of this rare disease are discussed.[ncbi.nlm.nih.gov]
Lower Extremity Pain
  • Popliteal artery entrapment syndrome (PAES) is a rare condition that should be suspected in a young patient with exertional lower extremity pain.[ncbi.nlm.nih.gov]
  • A 32-year-old health worker (medical doctor) applied to our clinic with a complaint of lower extremity pain, paleness, and coldness, post-exercise. He did not have any complaint to make him think as ischemia.[ncbi.nlm.nih.gov]
  • The etiology of lower extremity pain in the younger population (under 40) at rest or with exercise is overwhelmingly a result of musclo sketal disorders.[miamivascular.com]
Vascular Disease
  • Popliteal artery entrapment syndrome is a rare but potentially limb threatening peripheral vascular disease occurring predominantly in young adults.[ncbi.nlm.nih.gov]
  • There was no past history of vascular disease. Neither the arteriography nor the arterial doppler led to definite diagnosis. In our case, only the C.T. scan was contributive to the diagnosis.[ncbi.nlm.nih.gov]
  • Popliteal artery entrapment syndrome is an uncommon cause of peripheral vascular disease in young fit individuals, presenting as progressive claudication or sudden limb ischaemia.[ncbi.nlm.nih.gov]
  • Due to extensive vascular disease, grafting was not possible and a below-knee amputation was performed. It is therefore essential to diagnose popliteal artery syndrome early for appropriate management.[ncbi.nlm.nih.gov]
  • Healthy athletes without peripheral vascular disease and symptomatic calf and foot claudication should have an early referral to vascular surgery.[ncbi.nlm.nih.gov]
Calf Pain
  • This patient had a classic history of calf pain that worsened with walking and was relieved by rest, running, or bicycle riding.[ncbi.nlm.nih.gov]
  • pain during exercise, though bilateral involvement has been reported to occur in as high as 67% of affected patients.[eorif.com]
  • The consequence of reduced flow from calf contraction is immediate and leads to cramping and calf pain during exercise.[hopkinsmedicine.org]
  • Title Young athlete with bilateral exertional calf pain Recommended Citation Dunbar S, Englund J. Young athlete with bilateral exertional calf pain. J Patient-Centered Res Rev. 2014;1:50.[digitalrepository.aurorahealthcare.org]
  • Symptom Popliteal arterial syndrome syndrome common symptoms dorsalis pedis artery pulsation disappear calf swelling pain calf pain after walking calf muscle spasm skin pale intermittent claudication muscle atrophy To improve the understanding of PAES[healthfrom.com]
Foot Drop
  • Often, it affects young athletic males, with symptoms like calf claudication, weakness, numbness, pain, coldness of the foot, cramps, foot drop and paresthesia.[fupress.net]

Workup

  • A full clinical workup was performed on the patient, revealing noncontributory family history, normal laboratory analysis and an inconclusive MRI (magnetic resonance imaging) showing no pathology to explain the clinical symptoms.[miamivascular.com]
  • Sounds like your surgeon is doing appropriate workup. Good luck. denial - it's not just a river in Egypt Thanks for your reply![forum.slowtwitch.com]
  • Additional workup, including compartment pressure measurements at rest and after exercise, completed prior to her presentation to the authors' office had negative results for exertional compartment syndrome.[healio.com]
  • Differential diagnoses in the workup of exercise-induced leg pain should include musculotendinous injury, exertional compartment syndrome, popliteal artery entrapment syndrome, medial tibial stress syndrome (MTSS) and stress fracture.[podiatrytoday.com]

Treatment

  • At present, the role of the endovascular technique for PAES is still mainly auxiliary, there is no successful case treated successfully by endovascular treatment without open surgery, and also the long-term follow-up after endovascular treatment are lacking[ncbi.nlm.nih.gov]
  • Femoral embolectomy does not have any aid to treatment.[ncbi.nlm.nih.gov]
  • Hybrid treatment combining embolization and surgery resulted in favorable outcome. This case emphasizes the need for long-term follow-up after surgical treatment of PAES.[ncbi.nlm.nih.gov]
  • Currently, its treatment is based only on surgery with variable results.[ncbi.nlm.nih.gov]
  • Symptomatic PAES in children should be considered a severe condition requiring urgent investigation in order to avoid any delays in the treatment. Early diagnosis and treatment are essential to prevent serious complications.[ncbi.nlm.nih.gov]

Prognosis

  • The disease incidence, clinical features, pathology, investigations, treatment and prognosis are reviewed.[ncbi.nlm.nih.gov]
  • This article explains the condition, its classification and the key examination findings, allowing differentiation from other diagnoses, as well as advice on management, definitive treatment and prognosis.[ncbi.nlm.nih.gov]
  • However, if the diagnosis is made early, the prognosis is usually favorable, following appropriate surgical treatment.[ncbi.nlm.nih.gov]
  • Follow-up in all patients at long term showed good prognosis. All of the patients were able to take up their previous physical activities without sequelae.[ncbi.nlm.nih.gov]
  • However, the little research that has been done to determine the prognosis for individuals who have undergone surgery has focused on the patency rate of the arteries after surgery and the presence or absence of complications.[ncbi.nlm.nih.gov]

Etiology

  • The etiology of lower extremity pain in the younger population (under 40) at rest or with exercise is overwhelmingly a result of musclo sketal disorders.[miamivascular.com]
  • The etiology of this syndrome is related to anatomical variations determining an altered relationship between popliteal artery and the surrounding structures.[fupress.net]
  • […] encounter see all Popliteal artery ICD-10 codes A- initial encounter D- subsequent encounter S- sequela Popliteal Artery Entrapment Syndrome ICD-9 904.4 Injury to blood vessels of lower extremity; popliteal blood vessels Popliteal Artery Entrapment Syndrome Etiology[eorif.com]
  • Treatment Treatment of PAES depends upon the etiology.[journals.lww.com]

Epidemiology

  • Popliteal artery ICD-10 codes A- initial encounter D- subsequent encounter S- sequela Popliteal Artery Entrapment Syndrome ICD-9 904.4 Injury to blood vessels of lower extremity; popliteal blood vessels Popliteal Artery Entrapment Syndrome Etiology / Epidemiology[eorif.com]
  • […] gastrocnemius), medial tibia stress syndrome, fibular and tibial stress fractures, fascial defects, nerve entrapment syndrome, vascular claudication (atherosclerotic or popliteal artery entrapment syndrome) and referred pain from lumbar disc herniation. [3] Epidemiology[en.wikipedia.org]
  • EPIDEMIOLOGY Necropsies performed by Gibson et al. and Paulo 5,6 revealed anomalies of the popliteal fossa in 3.4% and 3.3%, respectively.[jvascbras.com.br]
Sex distribution
Age distribution

Pathophysiology

  • Keywords Popliteal artery; Claudication; Anatomic variation; Pathophysiology Introduction Exertional leg pain is a cause of significant morbidity and limitation of activity to athletes and those who exercise.[omicsonline.org]
  • 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.[e-sciencecentral.org]
  • Pathophysiology Popliteal artery entrapment syndrome usually occurs in younger patients who are healthier and more active than average for their age group, usually sportsmen requiring repeated sudden and forceful contraction of the calf which leads to[boneandspine.com]
  • […] findings Fullness of legs after activity, normal results on pulse examination Foot coldness, absent pulses in later stages Diagnostic studies Abnormal compartment pressure measurements after exercise Dynamic ultrasound and magnetic resonance angiogram Pathophysiology[healio.com]
  • In this kind of entrapment, the absence of anatomic anomalies led to other pathophysiological mechanisms as the cause of symptoms. 4,11 Rignault et al., after treating an individuals with PAES in 1985, 10 believed this type of disease affected athletes[jvascbras.com.br]

Prevention

  • Accurate assessment and monitoring are critical in identifying this syndrome, minimizing complications, and preventing long-term adverse effects on activities of daily living.[ncbi.nlm.nih.gov]
  • The mainstay of treatment is prevention of PA fibrosis because if left untreated, the syndrome leads to irreversible damage to the PA with thrombosis and limb ischemia.[ncbi.nlm.nih.gov]
  • Early diagnosis and treatment can prevent limb loss and lead to a good operative outcome.[ncbi.nlm.nih.gov]
  • Further study will help determine the optimum dose and frequency of injection to prevent recurrence of symptoms.[ncbi.nlm.nih.gov]
  • Prompt diagnosis and surgical treatment are key to complete recovery and the prevention of irreversible complications that may result in limb loss.[ncbi.nlm.nih.gov]

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