Article ; Online: Improving duplex ultrasound methods for diagnosing functional popliteal artery entrapment syndrome.
Scandinavian journal of medicine & science in sports
2024 Volume 34, Issue 3, Page(s) e14592
Abstract: Objectives: Popliteal artery entrapment syndrome (PAES) is a rare condition where musculoskeletal structures compress the popliteal artery (POPA) leading to vascular compromise. This study investigates the effect of dynamic plantar- and dorsi-flexion ... ...
| Abstract | Objectives: Popliteal artery entrapment syndrome (PAES) is a rare condition where musculoskeletal structures compress the popliteal artery (POPA) leading to vascular compromise. This study investigates the effect of dynamic plantar- and dorsi-flexion loading on POPA hemodynamic parameters to develop a robust diagnostic ultrasound-based protocol for diagnosing functional PAES. Methods: Healthy individuals (n = 20), recreational athletes (n = 20), and symptomatic (n = 20) PAES patients were consented. Triplex ultrasound imaging of lower limb arteries was performed (n = 120 limbs). Proximal and distal POPA's in dorsi-/plantar-flexion, in prone and erect positions, were imaged at rest and flexion. Peak systolic velocities (cm/s) and vessel diameter (antero-posterior, cm) was measured. Results: Distal vessel occlusion was noted across all three groups whilst prone during plantar-flexion (62.7%). POPA occlusion was only noted in the proximal vessel within the patient group (15.8%). When prone, 50% of control (n = 40 limbs), 70% of athletes (n = 40 limbs), and 65% of patients (n = 40 limbs) had distal POPA occlusion in plantar-flexion. When prone, recreational athletes (5%), and patients (12.5%) had distal POPA compression under dorsi-flexion. POPA occlusions with the patient in erect position were only noted in the symptomatic patient group under both dorsi-flexion (15.8%) and plantar-flexion (23.7%). Conclusion: Compression of the POPA on ultrasound should not be the sole diagnostic criteria for PAES. POPA compression exists in asymptomatic individuals, primarily under prone plantar-flexion. To reduce false positives, ultrasound-based protocols should focus on scanning patients in the erect position only to diagnose PAES, rather than asymptomatic POPA compression. A distinction should be made between the two. |
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| MeSH term(s) | Humans ; Arterial Occlusive Diseases/diagnostic imaging ; Popliteal Artery Entrapment Syndrome ; Peripheral Arterial Disease ; Hemodynamics ; Ultrasonography |
| Language | English |
| Publishing date | 2024-03-07 |
| Publishing country | Denmark |
| Document type | Journal Article |
| ZDB-ID | 1077418-x |
| ISSN | 1600-0838 ; 0905-7188 |
| ISSN (online) | 1600-0838 |
| ISSN | 0905-7188 |
| DOI | 10.1111/sms.14592 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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