Surgical treatment for popliteal artery entrapment syndrome

Ann Vasc Dis. 2014;7(1):28-33. doi: 10.3400/avd.oa.13-00081. Epub 2014 Feb 4.

Abstract

Objective: To evaluate the long-term outcomes of surgical treatment for popliteal artery entrapment syndrome (PAES).

Materials and methods: This study was undertaken from a retrospective review of case notes of patients treated for PAES between August 1974 and July 2013. We examined patients' characteristics and surgical procedures, and evaluated long-term outcomes including clinical symptoms and graft or native artery patency.

Results: Twenty-nine limbs (24 patients, mean age: 32 years) underwent surgery. Popliteal arteries were occluded (n = 18) stenosed (n = 7) and normal (n = 4). Twenty-five limbs required both revasularization (interposition [n = 24] and bypass surgery [n = 1]) and myotomy. Four limbs were treated solely with myotomy. During the long-term follow-up period, three limbs required reoperation. The overall primary graft and native popliteal artery patency rates at one and 5 years were 96.3% and 91.9%, respectively.

Conclusion: The treatment of PAES with myotomy and selective revascularization achieves good short- and long-term outcomes. The use of an interposition vein graft reconstruction is associated with minimal morbidity and good long-term patency.

Keywords: autogenous vein graft; intermittent claudication; medial head of the gastrocnemius muscle; popliteal artery entrapment syndrome.