To remind a rare cause of bilateral popliteal artery occlusion in young adults: popliteal artery entrapment syndrome and to emphasize the importance of early diagnosis.

Introduction: Popliteal artery entrapment syndrome (PAES) is a rare entity caused by developmentally abnormal relationship between popliteal artery (PA) and surrounding musculotendinous structures, mostly medial head of gastrocnemius muscle and rarely an anomalous fibrous band or popliteus muscle (1). It results in extrinsic arterial compression and because of the repetitive insult to the popliteal artery, in the later stages of undiagnosed PAES aneurysm, thromboembolism and complete arterial occlusion can occur (2). Although the anatomic anomalies may be seen in up to %3 of the population...

Magnetic Resonance Angiography (MRA)of the lower limb arteries revealed complete occlusion of the right PA and occlusion of the proximal half of the left PA. There were also multiple collateral arteries, arising from superficial femoral arteries, supplying right crural arteries and distal half of left PA (Figure 1). Axial T1 and T2 weighted MR images of both popliteal fossas showed aberrant attachments of the medial heads of both gastrocnemius muscles between the occluded PAs and patent popliteal veins (Figure 3).

PAES is a rare and unusual syndrome affecting predominantly young male adults but may cause complete obstruction of the popliteal artery leading to acute limb-threatening ischaemia. This syndrome is difficult to diagnose and therefore poses a diagnostic pitfall. Awareness of this entity is a prerequisite for correct and prompt diagnosis. It should be included in the differential diagnosis of acute popliteal artery occlusion or claudication in young patients with no cardiovascular risk factors. Early surgical intervention to release the popliteal artery is the treatment of...

1) Thanila A. Macedo, C. Michael Johnson, John W. Hallett Jr, Jerome F. Breen. Popliteal Artery Entrapment Syndrome: Role of Imaging in the Diagnosis. American Journal of Roentgenology. 2003;181:1259-1265. 2) Ramawad Soobrah, Adam Nawaz, Tahir Hussain. Popliteal Artery Entrapment Syndrome Presenting with Acute Limb Ischaemia: A Case Report. Case Report Med. 2010;2010:281925. 3) Radonić V, Koplić S, Giunio L, Bozić I, Masković J, Buća A. Popliteal artery entrapment syndrome: diagnosis and management, with report of three cases. Tex Heart Inst J. 2000;27(1):3-13. 4) Elias DA,...

* Esin Gezmis, M.D., Instructor of Radiology, Baskent University Faculty of Medicine Zubeyde Hanim Practice and Research Center, Department of Radiology * Cihan Altın, M.D.,Assistant Professor, Baskent University Faculty of Medicine Zubeyde Hanim Practice and Research Center, Department of Cardiology * Enes Duman, M.D., Instructor of Radiology, Baskent University Faculty of Medicine Konya Practice and Research Center, Department of Radiology * Elcin Aydin, M.D., Instructor of Radiology, Baskent University Faculty of Medicine Zubeyde Hanim Practice and Research Center, Department of Radiology