Br Med Bull. 2026 Oct 5;160(1):ldag034. doi: 10.1093/bmb/ldag034.
ABSTRACT
INTRODUCTION: Popliteal artery entrapment syndrome (PAES) results from extrinsic compression of the popliteal artery as it passes through the popliteal fossa due to congenital musculotendinous anomalies or acquired muscle hypertrophy. The consequence of this compression is a progressive damage to the arterial wall, which can ultimately cause irreversible injury. This damage initially manifests as intermittent claudication, which usually occurs in young, athletic individuals with no cardiovascular risk factors. There may be an overlap of symptoms with other conditions, making diagnosis challenging. Beyond clinical suspicion, dynamic tests with provocation manoeuvres are essential. Early decompression treatment of symptomatic cases can prevent the onset of potentially serious complications, including amputation.
SOURCES OF DATA: This review integrates evidence from peer-reviewed literature focusing on popliteal entrapment syndrome.
AREAS OF AGREEMENT: Shortening the timeline from diagnosis to referral can help prevent irreversible damage to the arteries.There are a significant number of publications on PAES, based on retrospective single-centre experiences, short series or case reports, and limited scientific evidence. All publications repeatedly conclude that prospective multicentre studies are needed to standardize diagnostic and therapeutic protocols and develop guidelines for PAES.
AREAS OF CONTROVERSY: There are many points of disagreement regarding the management of PAES, and this does not help in addressing two key issues: avoiding misdiagnosis and unnecessary surgeries, which promote delayed diagnosis in worse clinical conditions.
GROWING POINTS: The creation of multicentre working groups seems necessary due to the limited number of cases at individual centres for conducting prospective studies.
AREAS TIMELY FOR DEVELOPING RESEARCH: Creation of international consensus protocols on definition, diagnosis, and treatment of PAES.
PMID:42893552 | DOI:10.1093/bmb/ldag034