Response of the popliteal artery to treadmill exercise and stress positioning in patients with and without exertional lower extremity symptoms

Review written by Dr Carlo Wood info

Key Points

  1. All exertional leg pain and neurologic symptom (ELPNS) sufferers in this study had peripheral arteries (PAs) that either occluded or decreased in diameter with plantar flexion compared with the PAs in asymptomatic subjects.
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BACKGROUND & OBJECTIVE

Patients with exertional leg pain and neurologic symptoms (ELPNS) dissimilar to intermittent claudication and lacking peripheral artery (PA) disease are often treated incorrectly. PA entrapment syndrome (PAES) is a possible cause of ELPNS where the PA is entrapped by the gastrocnemius above or behind the knee. Below the knee, the proximal attachment of the soleus muscle to the tibia can compress the PA, tibial nerve, and popliteal vein. Symptoms arising here differ from pure arterial compression and consist of paresthesia, anesthesia, or weakness. This study aimed to determine the utility of exertional ankle brachial index (EABI) and ultrasound of the popliteal outlet in discriminating between limbs with and without ELPNS.

Peripheral artery entrapment syndrome is a possible cause of exertional leg pain and neurologic symptoms where the artery is entrapped by the gastrocnemius above or behind the knee.
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Utilizing the tests in this study to rule in or out the peripheral artery can assist greatly in differential diagnosis of the vascular system in exertional leg pain and neurologic symptom sufferers.

METHODS

The intent was to examine a cohort of patients with undifferentiated ELPNS. Ultrasound was performed of the below knee PA as the ankle was flexed and extended determining the point of maximal compression at the soleus muscle. Peak systolic velocity

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