{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T06:05:39Z","timestamp":1792389939869,"version":"4.4.0"},"reference-count":12,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,3,8]],"date-time":"2024-03-08T00:00:00Z","timestamp":1709856000000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Scandinavian Med Sci Sports"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Popliteal artery entrapment syndrome (PAES) is a rare condition where musculoskeletal structures compress the popliteal artery (POPA) leading to vascular compromise. This study investigates the effect of dynamic plantar\u2010 and dorsi\u2010flexion loading on POPA hemodynamic parameters to develop a robust diagnostic ultrasound\u2010based protocol for diagnosing functional PAES.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Healthy individuals (<jats:italic>n<\/jats:italic>\u2009=\u200920), recreational athletes (<jats:italic>n<\/jats:italic>\u2009=\u200920), and symptomatic (<jats:italic>n<\/jats:italic>\u2009=\u200920) PAES patients were consented. Triplex ultrasound imaging of lower limb arteries was performed (<jats:italic>n<\/jats:italic>\u2009=\u2009120 limbs). Proximal and distal POPA's in dorsi\u2010\/plantar\u2010flexion, in prone and erect positions, were imaged at rest and flexion. Peak systolic velocities (cm\/s) and vessel diameter (antero\u2010posterior, cm) was measured.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Distal vessel occlusion was noted across all three groups whilst prone during plantar\u2010flexion (62.7%). POPA occlusion was only noted in the proximal vessel within the patient group (15.8%). When prone, 50% of control (<jats:italic>n<\/jats:italic>\u2009=\u200940 limbs), 70% of athletes (<jats:italic>n<\/jats:italic>\u2009=\u200940 limbs), and 65% of patients (<jats:italic>n<\/jats:italic>\u2009=\u200940 limbs) had distal POPA occlusion in plantar\u2010flexion. When prone, recreational athletes (5%), and patients (12.5%) had distal POPA compression under dorsi\u2010flexion. POPA occlusions with the patient in erect position were only noted in the symptomatic patient group under both dorsi\u2010flexion (15.8%) and plantar\u2010flexion (23.7%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Compression of the POPA on ultrasound should not be the sole diagnostic criteria for PAES. POPA compression exists in asymptomatic individuals, primarily under prone plantar\u2010flexion. To reduce false positives, ultrasound\u2010based protocols should focus on scanning patients in the erect position only to diagnose PAES, rather than asymptomatic POPA compression. A distinction should be made between the two.<\/jats:p><\/jats:sec>","DOI":"10.1111\/sms.14592","type":"journal-article","created":{"date-parts":[[2024,3,9]],"date-time":"2024-03-09T03:18:43Z","timestamp":1709954323000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Improving duplex ultrasound methods for diagnosing functional popliteal artery entrapment syndrome"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3024-5183","authenticated-orcid":false,"given":"David W.","family":"Barrett","sequence":"first","affiliation":[{"name":"Independent Vascular Services Ltd, Wythenshawe Hospital, Manchester University NHS Foundation Trust  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joao","family":"Carreira","sequence":"additional","affiliation":[{"name":"Independent Vascular Services Ltd, Wythenshawe Hospital, Manchester University NHS Foundation Trust  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank L.","family":"Bowling","sequence":"additional","affiliation":[{"name":"School of Medical Sciences, Faculty of Biology, Medicine and Health University of Manchester, Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust  Manchester UK"},{"name":"Manchester Academic Vascular Research and Innovation Centre (MAVRIC), Manchester University NHS Foundation Trust  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leszek","family":"Wolowczyk","sequence":"additional","affiliation":[{"name":"Manchester Academic Vascular Research and Innovation Centre (MAVRIC), Manchester University NHS Foundation Trust  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1722-453X","authenticated-orcid":false,"given":"Steven K.","family":"Rogers","sequence":"additional","affiliation":[{"name":"School of Medical Sciences, Faculty of Biology, Medicine and Health University of Manchester, Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust  Manchester UK"},{"name":"Manchester Academic Vascular Research and Innovation Centre (MAVRIC), Manchester University NHS Foundation Trust  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,3,8]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2008.12.005"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/105953"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2017-098704"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radcr.2021.10.059"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.3400\/avd.oa.13-00081"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2008.10.019"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.180.3.1800627"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2018.08.171"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2011.10.013"},{"issue":"2","key":"e_1_2_9_11_1","first-page":"225","article-title":"Popliteal artery entrapment syndrome","volume":"55","author":"Lejay A","year":"2014","journal-title":"J Cardiovasc Surg"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0741-5214(99)70098-4"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2011.08.050"}],"container-title":["Scandinavian Journal of Medicine &amp; Science in Sports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/sms.14592","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,8]],"date-time":"2024-07-08T11:39:35Z","timestamp":1720438775000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/sms.14592"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3]]},"references-count":12,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2024,3]]}},"alternative-id":["10.1111\/sms.14592"],"URL":"https:\/\/doi.org\/10.1111\/sms.14592","archive":["Portico"],"relation":{},"ISSN":["0905-7188","1600-0838"],"issn-type":[{"value":"0905-7188","type":"print"},{"value":"1600-0838","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3]]},"assertion":[{"value":"2023-02-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-02-22","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-03-08","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e14592"}}