The popliteal artery is a relatively short vascular segment but is affected by a unique set of pathologic conditions. These conditions, which may be common throughout the arterial system or exclusive to the popliteal artery, include atherosclerosis, popliteal artery aneurysm, arterial embolus, trauma, popliteal artery entrapment syndrome, and cystic adventitial disease. The clinical manifestations, imaging appearances, and treatment options associated with these pathologic conditions differ significantly. Consequently, the radiologist should be familiar with these conditions to direct imaging for accurate diagnosis and treatment and to prevent loss of limb.

https://pubs.rsna.org/doi/pdf/10.1148/rg.242035117

Popliteal artery disease: diagnosis and treatment.

Popliteal Arterial Entrapment (PAE) was first reported in 1879 by Stuart, a medical student at the University of Edinburgh. Mr. Stuart observed, during the dissection of an amputated leg of a 64-year-old man, a popliteal artery coursing around the medial head of the gastrocnemius muscle and aneurysmal changes in the popliteal artery distal to the point of external muscular compression [1]. The first case of PAE was surgically treated in 1959, in a 12year-old boy complaining of claudication after walking 300 meters. At surgical exploration, Hamming, at Leyden University in The Netherlands, found an occluded artery with an anomalous course medial to the medial gastrocnemius muscle. He transected the muscle and performed a successful popliteal artery thromboendarterectomy [2]. In 1979 Rich et al. published the first series of patients treated for PAE [3]. Many case reports were published in the ensuing years, as well as other small series [4]. Efforts to revise collective series were incomplet for lack of details and patient follow-up [5]. The functional form of entrapment was first described by Rignault et al. in 1985 in a report describes cases in which the anatomy of the popliteal fossa is normal [6].

Popliteal vascular entrapment.

Popliteal artery entrapment syndrome: More common than previously recognized

Popliteal artery entrapment syndrome.

Leg pain in athletes has many aetiologies. The clinician must strive to specifically define the clinical problem in order to administer the appropriate treatment for the athlete’s condition. Clinical conditions in the leg causing symptoms in athletes include chronic exertional compartment syndrome (CECC), tendinitis, medial tibial stress syndrome, stress fractures, fascial defects, musculotendinous junction disruptions (tennis leg), popliteal artery entrapment syndrome, effort-induced venous thrombosis and nerve entrapment. Appropriate diagnostic studies are needed to allow accurate diagnosis. A work-up might include radiographs, bone scans and compartment pressure measurement. Many of these conditions relate to overuse and training errors. Conservative measures including rest, activity modification and rehabilitation will permit a gradual return to participation in sports. Some problems, such as CECC, popliteal artery entrapment syndrome and nerve entrapment may require surgical intervention to allow the resolution of symptoms. Clinicians should be familiar with the range of problems causing leg pain in order to prescribe specific treatment for each athlete.

Lower leg pain. Diagnosis and treatment of compartment syndromes and other pain syndromes of the leg.

https://www.jvascsurg.org/article/0741-5214(94)90236-4/pdf

Popliteal vascular compression in a normal population

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Popliteal vascular compression in a normal population