Popliteal Entrapment in a 16‐Year‐Old Soccer Player Treated via Detachment and Repositioning of the Medial Head of the Gastrocnemius

Background Popliteal artery entrapment syndrome (PAES) is a frequently underdiagnosed disease in young patients due to its low incidence and nonspecific symptoms. The disease is classified broadly into two categories: anatomic entrapment or functional entrapment. Prompt diagnosis is crucial due to the potentially limb‐threatening nature of this condition should critical limb ischemia develop. Case A 16‐year‐old male soccer player with no past medical history who had 1 week of acute onset right lower extremity calf pain and foot numbness due to right proximal popliteal and tibial artery occlusion in the setting of Type 1 popliteal artery entrapment. Treatment initially included thrombolysis but was complicated by development of compartment syndrome requiring emergent four‐compartment fasciotomy. He subsequently underwent thrombectomy of his popliteal, anterior, and posterior tibial arteries before definitive popliteal artery decompression with medial gastrocnemius recession and repositioning. Discussion PAES is a rare disease that can lead to devastating complications such as critical limb ischemia as seen in this patient. It is of paramount importance to identify this disease early and implement appropriate treatment. Debate remains as to the necessity of bypass or vascular repair in patients with Type 1 PAES. This patient did not undergo popliteal artery bypass and has been doing well postoperatively thus far.