It usually occurs due to anatomical abnormalities that pertain to how the artery develops during its embryonic stages. Sometimes, there are ‘functional’ entrapments, which means no anatomical abnormality is identified, but there is some other cause for the artery being compressed and compromised.
Pain, cramping, and numbness in the calf, especially during exercise, and coldness or discolouration of the foot.
Chronic exertional compartment syndrome
Surgery to release the trapped artery is often recommended to restore proper blood flow and prevent complications.
There are six main types of popliteal artery entrapment, each with a different surgical solution. A thorough imaging investigational workup is required to diagnose the abnormality and plan intervention.
Prior to surgery, the following investigations may be requested:
1. Arterial and venous duplex (ultrasound) with provocative manoeuvres
2. MRI to delineate any abnormal anatomy. This helps plan the correct surgical approach
3. Arterial angiogram with provocative manoeuvres to confirm any requirement for arterial reconstruction, if there is evidence of damage to the popliteal artery
Surgery
The two surgical approaches include either:
1. A medial approach (on the side of the calf that faces the other leg)
2. A posterior approach (around the knee crease)
Each approach has its advantages and disadvantages, and is selected based on the anatomical problem identified on imaging.
