Doppler Ultrasound Evaluation of Patients with Popliteal Vascular Entrapment Syndrome

Abstract Background To retrospectively evaluate Doppler ultrasound findings for patients with popliteal vascular entrapment syndrome (PVES). Methods Twenty-four patients (30 legs) who underwent surgical intervention for PVES were included in this study. The popliteal artery, popliteal vein, and surrounding musculotendinous structures were explored in all symptomatic lower extremities using ultrasound. Intraoperative findings served as the gold standard. In the absence of popliteal artery occlusion, popliteal arteries were examined using Doppler ultrasound at rest and during a provocative maneuver. Results Ultrasonography in 25 cases (25/30, 83%) showed that gastrocnemius medial head or popliteal vascular anomalies were consistent with surgical photography results. According to Whelan and Rich classification, the classic type I was found in five limbs, type II in twelve limbs, type III in seven limbs, and type V in one limb. In the remaining five cases (5/30, 17%), no anatomical abnormalities of the popliteal fossa were discovered by the ultrasound examination. Among these, two cases (2/30, 7%) were misdiagnosed as lower extremity atherosclerosis and popliteal vascular depression was not found. In addition, increasing blood flow velocity was found in three cases (3/30, 10%) of compressed popliteal arteries using Duplex scanning during active plantar flexion, with decreasing flow at the distal end. Color Doppler ultrasound of the affected popliteal vessels showed varied degrees of vascular structure pathology, including arterial stenosis in ten limbs, occlusion in fifteen limbs, and aneurysm in two limbs. Conclusion Doppler ultrasound may have a high diagnostic rate in PVES. Due to its simplicity, repeatability, functional evaluation of blood flow, and non-invasiveness, it can be used as a primary screening examination modality in PVES. Provocative maneuvers could help clinicians diagnose PVES.