Surgical aspects of popliteal artery entrapment syndrome: 26 years of experience with 26 legs.
The authors present their experience in diagnosis, therapy and follow up of the Popliteal Artery Entrapment Syndrome (PAES) during the last 26 years. PAES appears most frequently in young athletic male patients. From 1967 to 1993, 20 patients, 17 male (85%) and 3 female (15%), with 26 entrapment legs were treated. Average age at the time of the first symptoms was 33.5 years and at the time of diagnosis 38.5 years. Six patients suffered from PAES on both legs. In 5 of the 24 operated cases a re-operation was necessary. One case required a third operation. To reduce the postoperative complication rate, surgical technique was chosen according to the anatomical situation. If there was only slight disease of the popliteal wall, the current surgical technique consisted in decompressing the artery and replacing it in the orthotopic position through a direct entrance with the patient in the prone position. If there was severe disease of the popliteal wall, an autologous venous bypass from the popliteal artery segment I to segment III should be done with the patient supine. In our opinion, a primary catheter lysis therapy, which can be indicated for stenosed arteries, should not be done for peristenotic aneurysms. Successful therapy of PAES largely depends on early diagnosis that has been confirmed by CT scan.
Zünd
G
G
Department of Surgery, University Hospital Zurich, Switzerland.
Brunner
U
U
D000293:Adolescent; D000328:Adult; D000368:Aged; D003251:Constriction, Pathologic / Q000175:diagnosis / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007511:Ischemia / Q000175:diagnosis / Q000601:surgery*; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000002:abnormalities* / Q000601:surgery; D011150:Popliteal Artery / Q000601:surgery*; D012189:Retrospective Studies; D014680:Veins / Q000637:transplantation