External compression of the popliteal artery is probably still underdiagnosed. Repeated minor trauma to the popliteal artery as it passes through anomalous fibrous bands, due to developmental defects, may lead to stenosis and occlusion, with consequent chronic or acute ischaemic symptoms, usually in young males without cardiovascular risk factors. Distal embolization to the tibial arteries, to the foot arch and digital vessels is common but is not emphasized in the literature. This distal embolization may compromise the results of surgical repair. Early repair of the anomaly fibrous band is advocated even in a still asymptomatic lower limb. One patient with bilateral popliteal artery entrapment, causing unilateral occlusion, with distal embolization, is reported.
