title: Popliteal Artery Entrapment Syndrome in Children: Experience With Four Cases of Acute Ischaemia and Review of the Literature.
abstract: OBJECTIVE
  Popliteal artery entrapment syndrome (PAES) is an uncommon anatomical anomaly, frequently described in adults. The most common symptom is claudication. Acute limb ischaemia (ALI) in children is rare, but it may evolve and lead to limb loss or lifelong complications. Clinical and surgical experience of PAES in children is reported. Data from the literature are analysed in order to assess the severity of this disease and to identify the factors characterising the diagnosis and the outcome of treatment in paediatric patients.
  
  
  METHODS
  Four children (aged 7-16 years) were referred with ALI due to PAES. Among the 439 articles reporting cases of PAES, 55 patients under 18 years of age were the focus. The PAES cases were classified according to the Love and Whelan classification modified by Rich.
  
  
  RESULTS
  Data from 79 children (106 limbs, 27 bilateral PAES) were collected and analysed. Type I PAES was present in 41 (39%), Type II in 23 (22%), Type III in 24 (23%), Type IV in 12 (11%), and Type V in two (2%) limbs. A functional PAES was present in one patient bilaterally. In two cases, the type of PAES was not reported. Claudication occurred in 68 cases (64%), and ALI in 19 (18%). In 60 cases (57%), revascularisation with or without myotomy was required; myotomy alone was performed in 41 cases (39%).
  
  
  CONCLUSIONS
  Symptomatic PAES in children should be considered a severe condition requiring urgent investigation in order to avoid any delays in the treatment. Early diagnosis and treatment are essential to prevent serious complications. The long-term outcomes of surgical treatment with the correction of the anatomical anomaly and vascular reconstruction are satisfactory with a low complication rate.
authors.affiliation: Department of Vascular Surgery, Nancy University Hospital, University of Lorraine, Nancy, France. Electronic address: nicla.settembre@yahoo.com.
authors.forename: N
authors.initials: N
authors.lastname: Settembre
authors.affiliation: Department of Vascular Surgery, Nancy University Hospital, University of Lorraine, Nancy, France.
authors.forename: Z
authors.initials: Z
authors.lastname: Bouziane
authors.affiliation: Department of Vascular Surgery, Marseille University Hospital, Marseille, France.
authors.forename: M A
authors.initials: MA
authors.lastname: Bartoli
authors.affiliation: Department of Vascular Surgery, Saint Petersburg University Hospital, Saint Petersburg, Russia.
authors.forename: V
authors.initials: V
authors.lastname: Nabokov
authors.affiliation: Department of Vascular Surgery, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.
authors.forename: M
authors.initials: M
authors.lastname: Venermo
authors.affiliation: Department of Vascular Surgery, Lyon University Hospital, Lyon, France.
authors.forename: P
authors.initials: P
authors.lastname: Feugier
authors.affiliation: Department of Vascular Surgery, Nancy University Hospital, University of Lorraine, Nancy, France.
authors.forename: S
authors.initials: S
authors.lastname: Malikov
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D007511:Ischemia / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D058729:Peripheral Arterial Disease / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D011150:Popliteal Artery / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures
keywords: Acute limb ischaemia; Adolescents; Children; Paediatric patients; Popliteal artery entrapment syndrome; Revascularisation