A 19-year-old footballer has right calf claudication after running, relieved by rest. He has no vascular risk factors and normal ABI at rest, but ABI falls after exercise. Angiography shows medial deviation of the popliteal artery with focal narrowing only on plantar flexion. What is the definitive management?

• A Supervised exercise programme and antiplatelet therapy
• B Popliteal artery balloon angioplasty
• C Popliteal-to-tibial bypass with reversed saphenous vein
• D Surgical division of the anomalous musculotendinous band and arterial release ✓

Explanation

Popliteal artery entrapment is caused by an aberrant relationship between the popliteal artery and the medial head of gastrocnemius or accessory fibrous bands. It affects young athletes, produces positional compression, and causes chronic wall injury that can progress to occlusion. Definitive treatment is early operative release of the offending structure before irreversible arterial damage occurs. Angioplasty fails because the external compression recurs, and bypass is reserved for established occlusive damage.

Reference: Bailey and Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.