Bilateral asymmetric popliteal entrapment syndrome treated with successful surgical decompression and adjunctive thrombolysis

Popliteal artery entrapment syndrome (PAES) is the most common cause of lower leg claudication in patients younger than 50 years. The different types of PAES can result in different rates of arterial damage, leading to aneurysmal degeneration or occlusion. We report a rare case of a young patient presenting with asymmetrical bilateral popliteal artery entrapment. Type III PAES on the right resulted in severe limb ischemia and was treated by division of the accessory tendon and replacement of damaged artery withvein graft. On the left, the medial head of gastrocnemius was resected to release a type I PAES.