Intraoperative duplex and functional popliteal entrapment syndrome: strategy for effective treatment.
Functional popliteal entrapment syndrome (FPES) was first described by Rignault and colleagues in 1985 (Int. Angiol. 1985;4:341-343). This syndrome results from compression of the popliteal artery by a hypertrophied medial head of the gastrocnemius muscle with no other identifiable anatomical abnormality. The incidence, significance, natural history, and appropriate treatment of this syndrome remain controversial. We present three cases of FPES where intraoperative positional duplex scans guided gastrocnemius muscle resection and confirmed appropriate resection. Additionally, B-mode duplex obtained during one of the cases demonstrated intimal changes consistent with repetitive vessel trauma. All patients had resolution of their claudication and normal physiological testing postoperatively.
Department of Vascular Surgery, Madigan Army Medical Center, Tacoma, WA 98431, USA. mwcausey@msn.com
Marlin Wayne
MW
Causey
Niten
N
Singh
Seth
S
Miller
Reagan
R
Quan
Thomas
T
Curry
Charles
C
Andersen
D000328:Adult; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery; D003251:Constriction, Pathologic; D005260:Female; D006801:Humans; D007383:Intermittent Claudication / Q000209:etiology / Q000601:surgery; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000000981:diagnostic imaging* / Q000601:surgery; D009133:Muscular Atrophy / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D019637:Orthopedic Procedures; D011150:Popliteal Artery / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex; D018084:Ultrasonography, Interventional