Description

Entrapment of the popliteal artery syndrome (PAES) is an uncommon condition that affects the main artery behind the knee. Of the artery is called the popliteal artery. In this condition, the calf muscle is in the wrong position or it is larger than usual. The muscle exerts pressure on the artery. The artery is trapped, making it more difficult for the flow of blood to the lower part of the leg and the foot.

Entrapment of the popliteal artery syndrome is more common among athletes.

Symptoms

The main symptom of popliteal artery syndrome entrapment (PAES) is pain or cramping in the back of the lower leg. The back of the lower leg is called the calf. The pain occurs during exercise and goes away with rest. Other symptoms may include:

  • Cold feet after exercise.
  • Burning or tingling sensation in the calf.
  • Numbness in the calf area.

If the nearby vein, called the popliteal vein, he gets caught by the calf muscle, you can have:

  • A feeling of heaviness in the leg.
  • Bottom of the leg cramps at night.
  • Swelling in the calf area.
  • Changes in the color of the skin around the calf muscle.
  • Blood clot in the lower leg, called deep vein thrombosis.

The symptoms usually affect young, healthy people under the age of 40 years.

When to see a doctor

Make an appointment for a health checkup if you have any type of pain in the legs. This is especially important if you have the calf or foot cramps during the activity that improves with rest.

Causes

Entrapment of the popliteal artery syndrome (PAES) is caused by an irregularity of the calf muscle, usually the gastrocnemius muscle.

The condition can be seen in the birth, or it can occur later in life. When it is present at birth, the baby of the calf muscle, or in the vicinity of the artery forms in the wrong place during the pregnancy. The people who get the disease later in life has a calf muscle that is bigger than usual.

The changes in the calf muscle due to the press in the main artery behind the knee. This reduces the flow of blood to the lower part of the leg. The lack of blood flow causes pain and cramping in the back of the lower leg during times of activity.

Risk factors

Entrapment of the popliteal artery syndrome (PAES) is rare. The following factors increase the risk of the disease.

  • Younger age. The condition is more common in people who are in their late teens or 20 years. Rarely is diagnosed in people over 40 years of age.
  • The fact of being a man. PAES can occur in any person, but it is much more common in young men.
  • Strenuous athletic activity. Runners, cyclists and athletes who try to build muscle fast with weight training routines, or high-intensity circuit training are at the highest risk.

Complications

Long-term pressure in the popliteal artery can cause the artery to narrow. This is called stenosis of the artery. It can cause pain and cramps, with light activity, such as walking.

In severe cases or when it is not diagnosed, the nerves and the muscles of the leg may be damaged. Blood clots can occur in the lower part of the leg. Athletes of age with symptoms of entrapment of the popliteal artery syndrome should be reviewed by a balloon or dilation of the artery. This is called an aneurysm of the knee. It is common in men of advanced age.

Diagnosis

To diagnose the entrapment of the popliteal artery syndrome (PAES), the computer health checks you and will ask you questions about your symptoms and medical history. But because the majority of people with PAES are young and generally in good health, the diagnosis of the condition can sometimes be a challenge. There is usually no unusual findings of a physical examination.

Tests are done to rule out other causes of leg pain, including sprains, stress fractures, and peripheral arterial disease, which results from the blockage of the arteries.

The tests may include the following:

  • Ankle-brachial index (ABI) measurement is usually the first test done to diagnose PAES . Blood pressure measurements are taken in the arms and legs during, and after walking on a treadmill. The ABI is determined by dividing the ankle pressure by the arm pressure. The pressure of the blood in the legs should be greater than in the arms. But if you have PAES , your ankle pressure drops during exercise.
  • Duplex ultrasound of the lower leg uses high-frequency sound waves to show how fast blood moves through the arteries of the legs. This test can be performed before or after exercise. You may be asked to flex your foot up and down, that puts your calf muscle to work.
  • The magnetic resonance angiography (MRA) shows if the calf muscle is the capture of the artery. You can also say how much of the popliteal artery is reduced. You may ask you to flex your foot or press it against a table for this test. It helps to show how blood flows to the lower part of the leg.
  • CT angiography also shows that the muscle of the lower leg that is causing the entrapment of the artery. As MRA , you may be asked to move your foot during this test.
  • Catheter angiography shows how blood flows to and from the lower part of the leg in real-time. That is done if the diagnosis is not clear, even after other, less invasive imaging tests.

Treatment

If the entrapment of the popliteal artery syndrome (PAES) symptoms significantly affect the daily life or sports activities, surgery may be suggested. Surgery is the only way to fix the calf muscle and free the entrapment of the artery.

The surgery is performed in a hospital or medical facility while you are under general anesthesia. During the surgery, the surgeon makes an incision in the inner part of the calf, just below or at the back of the knee. This frees up the calf muscle to give the artery more space. The muscle of the calf no longer exerts pressure on the artery.

Entrapment of the popliteal artery syndrome surgery lasts about an hour. Normally, you will need to stay in the hospital for a day.

If you've had the condition for a long time and have a severe narrowing of the artery, you might need another surgery called a bypass of the artery.

Surgery to release the calf muscle and arteries, in general, do not affect the way the leg works. When the condition is diagnosed and treated early, a full recovery is expected, and the symptoms should disappear.

Preparing for your appointment

If you think you may have entrapment of the popliteal artery syndrome, it is important that you make an appointment for a health checkup. If it is detected early, treatment can be more easy, and can work better.

The health of the appointments can be brief. But there's often a lot to discuss. So it's a good idea to be prepared for your appointment. Here's some information to help you prepare.

What you can do

  • Be aware of any pre-appointment restrictions. Ask if you need to do anything prior to your appointment. For example, you may be asked not to eat or drink anything for a while before certain tests or surgical interventions.
  • Write down the symptoms you are experiencing, including any that may seem unrelated to the popliteal artery syndrome entrapment.
  • Write important personal information. Include a family history of heart disease, stroke, high blood pressure, or blood clots, and any major stresses or recent life changes.
  • Make a list of all medications, vitamins or supplements you are taking. Include the dose.
  • Have a family member or friend along, if possible. Sometimes it can be difficult to understand and remember all the information received during an appointment. The person who will be with you you can remember something that you missed or forgot.
  • Write down questions to ask your health care team.

Prepare a list of questions to ask the health care team can help you make the most of their time together. A list of questions from most important to least important in case time runs out. For the entrapment of the popliteal artery syndrome, some basic questions to ask include:

  • What is likely causing my symptoms?
  • What are other possible causes of the symptoms?
  • What kind of proof do you need?
  • What is the most appropriate treatment?
  • What is an appropriate level of physical activity?
  • What are the options for the treatment that you are suggesting?
  • I have other health conditions. How can I best manage them together?
  • Are there any restrictions that I need to follow?
  • Are there brochures or other printed material that I can take my house? What sites do you recommend to visit?

Do not hesitate to ask your health care team to answer any additional questions during your appointment.

What to expect from your doctor

Your health care team is likely that many questions. Be prepared to answer them you can save your time to go through any of the points that you want to devote more time. You may ask:

  • When did you first start having symptoms?
  • Do you always have symptoms, or come and go?
  • How severe are the symptoms?
  • What, if anything, seems to improve your symptoms?
  • What, in any case, it makes your symptoms worse?
Symptoms and treatment of the Popliteal artery syndrome entrapment