A 19-year-old male athlete complains of right calf claudication after running, relieved by rest. Examination is unremarkable at rest, but ankle pulses disappear with sustained knee flexion against resistance. Duplex shows loss of flow in the popliteal artery with plantarflexion. What is the most appropriate next step?
- A Lifelong antiplatelet therapy and statin
- B Surgical release of the anomalous musculotendinous band ✓
- C Percutaneous balloon angioplasty of the popliteal artery
- D Graded exercise programme and review in six months
Correct answer: B. Surgical release of the anomalous musculotendinous band
Explanation
Popliteal entrapment is caused by an aberrant medial head of gastrocnemius or fibrous band compressing the popliteal artery in young athletes. Diagnosis is confirmed by dynamic duplex or CT angiography showing compression on provocative manoeuvres. Treatment is surgical division of the constricting structure before irreversible arterial damage occurs. Angioplasty treats the consequence, not the cause, and exercise programmes delay definitive care.
Reference: Sabiston Textbook of Surgery, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.