Long-term outcomes of surgical treatment in patients with popliteal artery entrapment syndrome.
The object of the study is to determine the long-term outcomes of surgical treatment of patients with popliteal artery entrapment syndrome at a single institute. We retrospectively reviewed 19 limbs of 16 consecutive patients who underwent surgery for popliteal artery entrapment syndrome at our hospital over the past 36 years. The popliteal artery was stenotic in 11 limbs, occlusive in 7 limbs, and compressed and deviated by the medial head of the gastrocnemius muscle but not damaged in 1 limb. Six limbs were treated with autologous saphenous vein bypass, 10 with bypass or venous patch graft concomitant with musculotendinous section, and 3 limbs underwent musculotendinous section alone. The 10-year cumulative patency of the 13 limbs treated with bypass was 100%, although two of them showed occlusion at 23 and 12 years after surgery. One patient who received a venous patch graft showed occlusion 15 years after surgery. Additionally, one asymptomatic patient with an apparently non-damaged popliteal artery who received preventive musculotendinous section alone showed stenosis of the artery 2 years after musculotendinous section. In conclusion, the bypass patency observed in this study was excellent in the long term. Careful examination of popliteal artery anatomy using imaging studies is essential for selecting the appropriate surgical procedure for popliteal artery entrapment syndrome.
Department of Vascular Surgery, The University of Tokyo Hospital, Tokyo, Japan.
Satoshi
S
Yamamoto
Department of Vascular Surgery, The University of Tokyo Hospital, Tokyo, Japan traruba@gmail.com.
Katsuyuki
K
Hoshina
Department of Vascular Surgery, The University of Tokyo Hospital, Tokyo, Japan.
Akihiro
A
Hosaka
Department of Vascular Surgery, The University of Tokyo Hospital, Tokyo, Japan.
Kunihiro
K
Shigematsu
Department of Vascular Surgery, The University of Tokyo Hospital, Tokyo, Japan.
Toshiaki
T
Watanabe
D000293:Adolescent; D000328:Adult; D000368:Aged; D001157:Arterial Occlusive Diseases / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D003251:Constriction, Pathologic; D005260:Female; D006801:Humans; D007564:Japan; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000009:adverse effects; D018579:Patient Selection; D011150:Popliteal Artery / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D012501:Saphenous Vein / Q000637:transplantation*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D058017:Vascular Grafting / Q000009:adverse effects / Q000379:methods*; D014654:Vascular Patency; D055815:Young Adult
Popliteal artery entrapment syndrome; bypass; musculotendinous section; vein grafting