Popliteal Artery Entrapment Syndrome (PAES) is a rare vascular disease that usually affects the young adults and athletes. It is a consequence of an abnormal positioning of the popliteal artery in relation to its surrounding structures. Patient usually presented with intermittent claudication and in severe cases, patient may presented with acute vascular insufficiency.
We are report of a 32 years old soldier presented with intermittent claudication of the right leg for 2 years. The pain worsens for 2 months as the claudication distance reduced to 100 metres. He has no other risk except for heavy smoker. Examination shows the right leg was cold, no skin changes, intact sensory and the distal pulses was not palpable. Ankle brachial systolic index was 0.7. Digital substraction angiography of the right lower limb shows short segment chronic total occlusion of the distal superficial femoral artery. However there were reconstitution of the popliteal artery, anterior tibial artery and posterior tibial artery. Ultrasonography of the right leg shows the medial head of gastrocnemius impinge over the right popliteal artery. Intraoperative findings revealed Type II Popliteal Artery Entrapment Syndrome. Right myomectomy and popliteal bypass with interposition of vein graft was done. At follow-up, he has a complete resolution of his symptoms.
Popliteal Artery Entrapment Syndrome should be considered when dealing with young patients with claudication.