Sport-specific patterns of vascular compression in athletes with entrapment syndrome: A comparative analysis of endurance versus non-endurance athletes

This is the authors' abstract. We don't add key points for this paper.

Vascular entrapment syndromes of the lower extremities represent a diagnostic challenge in athletes, with emerging evidence suggesting sport-specific presentations. This study aimed to characterize and compare patterns of vascular compression, anatomical variants, and hemodynamic consequences across different sporting disciplines. We conducted a retrospective analysis of 210 athletes with confirmed vascular entrapment syndrome from a 10-year cohort (2014-2023). Athletes were categorized as long-distance runners (n=87), cyclists (n=71), triathletes (n=24), soccer players (n=19), and other sports (n=9). All participants underwent standardized clinical assessment and vascular imaging during provocative maneuvers. Multivariable analyses and latent class analysis were performed to identify independent predictors and distinct phenotypes. Sport-specific patterns of vascular compression were identified. Long-distance runners exhibited highest compression during plantarflexion (85.7±8.6%), predominantly with Type III gastrocnemius variants (60.9%). Cyclists demonstrated highest compression during knee extension (79.2±11.4%), with predominant Type II variants (49.3%). Soccer players exhibited primarily Type I variants (57.9%) with lower compression severity. Latent class analysis identified three distinct phenotypes: "runner phenotype" (43.8%), "cyclist phenotype" (37.1%), and "low compression phenotype" (19.0%), each with characteristic anatomical, hemodynamic, and clinical features. Sport category remained an independent predictor of compression severity after adjusting for potential confounders (p<0.001). Vascular entrapment syndrome manifests with distinct sport-specific patterns reflecting the interplay between anatomical predisposition and functional demands. The identification of sport-specific phenotypes provides a framework for tailored diagnostic approaches and management strategies. Recognition of these characteristics may enhance diagnostic accuracy, inform individualized treatment, and improve outcomes for affected athletes across diverse sporting disciplines.

Supports sport-specific vascular patterns in entrapment syndrome; leaves open tailored diagnostics pending prospective validation.