PMID- 19394547
OWN - NLM
STAT- MEDLINE
DCOM- 20090507
LR  - 20161125
IS  - 1097-6809 (Electronic)
IS  - 0741-5214 (Linking)
VI  - 49
IP  - 5
DP  - 2009 May
TI  - Functional popliteal artery entrapment syndrome: A poorly understood and often 
      missed diagnosis that is frequently mistreated.
PG  - 1189-95
LID - 10.1016/j.jvs.2008.12.005 [doi]
AB  - OBJECTIVES: Functional popliteal artery entrapment syndrome (FPAES) is an 
      uncommon overuse injury in young physically active adults manifest by 
      neuromuscular symptoms (gastroc/soleus cramping, plantar paresthesias). It is 
      commonly confused with chronic recurrent exertional compartment syndrome (CRECS). 
      This study evaluated the diagnostic testing, mechanism of injury, and treatment 
      differences between FPAES and CRECS. METHODS: Between 1987 and 2007, 854 patients 
      (557 women, 297 men; mean age, 28.5 years) were surgically treated for the 
      diagnosis of CRECS or FPAES, or both. Compartment pressures were measured in all 
      patients who had anterior lateral or posterior superficial calf symptoms (normal 
      pressure <or=15 mm Hg). Noninvasive stress positional plethysmography was 
      routine. Stress positional magnetic resonance imaging (MRI) or angiography (MRA) 
      was performed on patients with positive plethysmography result and symptoms 
      consistent with FPAES. RESULTS: Of the 854 patients, 757 (95%) had elevated 
      compartment pressures (>or=25 mm Hg), and fasciectomy was performed for CRECS 
      under local anesthesia (anterior lateral, 508; posterior superficial, 191; distal 
      deep posterior, 101). The result of stress plethysmography was positive in 139 
      (18%), but they were asymptomatic. Forty-three patients (27 women, 16 men; mean 
      age, 26.6 years) had positive stress plethysmography, appropriate FPAES symptoms, 
      and normal compartment pressures. MRA/MRI in all 43 demonstrated normal 
      musculotendinous anatomy and lateral neurovascular compression with plantar 
      flexion. Under general anesthesia, all had excision of the soleal band, with 
      relief from symptoms. In 19 of the 43 FPAES patients (44%), CRECS releases were 
      done before or after FPAES surgery. Follow-up ranged from 12 to 240 months. 
      CONCLUSION: FPAES and CRECS occur in the same population with similar symptoms 
      but require different treatment.
FAU - Turnipseed, William D
AU  - Turnipseed WD
AD  - University of Wisconsin Hospital, Madison, Wisc., USA. turnip@surgery.wisc.edu
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - J Vasc Surg
JT  - Journal of vascular surgery
JID - 8407742
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Arterial Occlusive Diseases/complications/*diagnosis/physiopathology/*surgery
MH  - Child
MH  - Compartment Syndromes/complications/*diagnosis/physiopathology/*surgery
MH  - Constriction, Pathologic
MH  - Diagnosis, Differential
MH  - Diagnostic Errors/prevention & control
MH  - Exercise Test
MH  - Fasciotomy
MH  - Female
MH  - Humans
MH  - Intermittent Claudication/*etiology/pathology/physiopathology/surgery
MH  - Magnetic Resonance Angiography
MH  - Male
MH  - Middle Aged
MH  - *Orthopedic Procedures
MH  - *Physical Exertion
MH  - Plethysmography
MH  - Popliteal Artery/pathology/physiopathology/*surgery
MH  - Predictive Value of Tests
MH  - Treatment Outcome
MH  - Young Adult
EDAT- 2009/04/28 09:00
MHDA- 2009/05/08 09:00
CRDT- 2009/04/28 09:00
PHST- 2008/08/18 00:00 [received]
PHST- 2008/12/01 00:00 [revised]
PHST- 2008/12/02 00:00 [accepted]
PHST- 2009/04/28 09:00 [entrez]
PHST- 2009/04/28 09:00 [pubmed]
PHST- 2009/05/08 09:00 [medline]
AID - S0741-5214(08)02129-0 [pii]
AID - 10.1016/j.jvs.2008.12.005 [doi]
PST - ppublish
SO  - J Vasc Surg. 2009 May;49(5):1189-95. doi: 10.1016/j.jvs.2008.12.005.