ArticleJournal of vascular surgery2025
Midterm outcomes from a 20-year experience treating functional popliteal artery entrapment syndrome in athletes.
Article in Journal of vascular surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- A novel approach to the treatment of functional popliteal artery entrapment syndrome in college athletes.Journal of vascular surgery cases and innovative techniques · 2026Article
- Short-term analysis of botulinum toxin A for functional popliteal artery entrapment syndrome.Journal of vascular surgery cases and innovative techniques · 2026Article
- Functional Outcome After Surgery for Popliteal Artery Entrapment Syndrome.EJVES vascular forum · 2026Article
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Authors and funding
6 authors.
Funding
Abstract
backgroundFunctional popliteal artery entrapment syndrome (FPAES) is a rare condition affecting young, active individuals presenting with claudication, swelling, or paresthesias, and often impairing athletic performance. Our standardized approach to this disease process involves testing with arterial duplex/digit plethysmography and provocative computed tomography angiography followed by surgical debulking consisting of popliteal artery release and resection of the anterolateral quadrant of the medial head of the gastrocnemius muscle and four-compartment fasciotomy. We sought to determine risk factors for clinical success vs recurrent symptoms in athletes undergoing surgery for FPAES.
methodsRetrospective review was conducted for consecutive athletes undergoing surgery for FPAES at a single institution. Demographics, preoperative symptoms, imaging findings, operative details, and postoperative outcomes were recorded, with primary outcome being return to prior level of sport, and secondary outcomes postoperative complications and long-term symptom recurrence.
resultsFrom 2005 to 2025, we operated on 125 limbs of 73 athletes. Most athletes competed at the collegiate level (38.4%), were female (64.5%), and had bilateral symptoms (84.2%). The most common sports represented were running (43.8%), soccer (26.0%), basketball (5.5%), lacrosse (5.5%), and water sports (5.5%). Surgical debulking was guided by computed tomography angiography compression of the gastrocnemius muscle and mean muscle volume resected was 6.86 cm
conclusionsFPAES is a rare yet impactful condition that limits athletes' ability to perform at high levels. This study represents the largest reported cohort to date, providing a 20-year experience of a standardized radiographic workup, symptom inventory, and definitive surgical treatment. Partial debulking of the medial head of the gastrocnemius after popliteal artery release is a safe and effective intervention, and when combined with concurrent fasciotomy seems to further improve outcomes. Male athletes seem to have improved outcomes with higher rates of return to sport and lower rates of symptom recurrence.
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