title: Popliteal endarterectomy for localized popliteal artery disease.
abstract: BACKGROUND
  The incidence of localized popliteal disease is rare. Currently, patients presenting with symptomatic popliteal disease are offered femoropopliteal or tibial bypass if the disease is not amenable to radiologic intervention. We feel that popliteal endarterectomy by means of a posterior approach with patch angioplasty as a primary procedure is a viable surgical option. Our aim was to assess the durability of popliteal endarterectomy in patients with localized popliteal disease, in which radiologic intervention is not feasible.
  
  
  METHODS
  This is a retrospective review of all patients who underwent popliteal endarterectomy for localized popliteal disease in our institution over the past 3 years. All patients underwent a preoperative assessment with computed tomography angiography. Angioplasty was attempted in all patients before surgical intervention. Patency was assessed radiologically 6 weeks after operation. Patients had follow-up appointments at intervals of 6 weeks, 3 months, 6 months, and a year after surgery.
  
  
  RESULTS
  A total of 7 patients (5 men and 2 women) underwent popliteal endarterectomy. The mean age was 64.3 years, with a mean follow-up period of 9.9 months (range, 2-26 months). Four patients were treated for activity-limiting claudication (<100 yards), whereas 3 patients were treated for ischemic rest pain. The procedural success rate was 100% without mortalities or in-hospital morbidities. Symptomatic resolution was achieved in 6 patients. One patient occluded 1 month after endarterectomy because of a critical stenosis at the tibial bifurcation.
  
  
  CONCLUSIONS
  Popliteal endarterectomy through posterior approach is advantageous in managing popliteal artery pathology restricted to the popliteal fossa. It is safe with good short-term results.
authors.affiliation: Walsall Manor Hospital, Walsall, West Midlands, UK. Electronic address: hosaamnasr@aol.com.
authors.forename: Hosaam
authors.initials: H
authors.lastname: Nasr
authors.affiliation: Russells Hall Hospital, Dudley, West Midlands, UK.
authors.forename: Simon
authors.initials: S
authors.lastname: Hobbs
authors.affiliation: Walsall Manor Hospital, Walsall, West Midlands, UK.
authors.forename: Chandra
authors.initials: C
authors.lastname: Abrew
mesh_terms: D000368:Aged; D004691:Endarterectomy / Q000009:adverse effects; D004739:England; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000175:diagnosis / Q000601:surgery*; D011150:Popliteal Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D012501:Saphenous Vein / Q000637:transplantation; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome