Surgical Treatment for Popliteal Artery Entrapment Syndrome

Kimihiro Igari; Norihide Sugano; Toshifumi Kudo; Takahiro Toyofuku; Masatoshi Jibiki; Yoshinori Inoue; Takehisa Iwai

doi:10.3400/avd.oa.13-00081

This article has now been updated. Please use the final version.

Surgical Treatment for Popliteal Artery Entrapment Syndrome

Kimihiro Igari, Norihide Sugano, Toshifumi Kudo, Takahiro Toyofuku, Masatoshi Jibiki, Yoshinori Inoue, Takehisa Iwai

Author information

Kimihiro Igari
Division of Vascular and Endovascular Surgery, Department of Surgery, Tokyo Medical and Dental University, Tokyo, Japan
Norihide Sugano
Department of Surgery, Tokyo Metropolitan Health and Medical Treatment Corporation Ohkubo Hospital, Tokyo, Japan
Toshifumi Kudo
Division of Vascular and Endovascular Surgery, Department of Surgery, Tokyo Medical and Dental University, Tokyo, Japan
Takahiro Toyofuku
Division of Vascular and Endovascular Surgery, Department of Surgery, Tokyo Medical and Dental University, Tokyo, Japan
Masatoshi Jibiki
Division of Vascular and Endovascular Surgery, Department of Surgery, Tokyo Medical and Dental University, Tokyo, Japan
Yoshinori Inoue
Division of Vascular and Endovascular Surgery, Department of Surgery, Tokyo Medical and Dental University, Tokyo, Japan
Takehisa Iwai
Tsukuba Vascular Center, Buerger Disease Research Institute, Moriya, Ibaraki, Japan

Keywords: popliteal artery entrapment syndrome, intermittent claudication, medial head of the gastrocnemius muscle, autogenous vein graft

JOURNAL FREE ACCESS Advance online publication

Article ID: oa.13-00081

DOI https://doi.org/10.3400/avd.oa.13-00081

The final version of this article is now available: Vol. 7 (2014), No. 1 pp. 28-33

Details

Abstract

Objective: To evaluate the long-term outcomes of surgical treatment for popliteal artery entrapment syndrome (PAES).Materials and Methods: This study was undertaken from a retrospective review of case notes of patients treated for PAES between August 1974 and July 2013. We examined patients’ characteristics and surgical procedures, and evaluated long-term outcomes including clinical symptoms and graft or native artery patency.Results: Twenty-nine limbs (24 patients, mean age: 32 years) underwent surgery. Popliteal arteries were occluded (n = 18) stenosed (n = 7) and normal (n = 4). Twenty-five limbs required both revasularization (interposition [n = 24] and bypass surgery [n = 1]) and myotomy. Four limbs were treated solely with myotomy. During the long-term follow-up period, three limbs required reoperation. The overall primary graft and native popliteal artery patency rates at one and 5 years were 96.3% and 91.9%, respectively.Conclusion: The treatment of PAES with myotomy and selective revascularization achieves good short- and long-term outcomes. The use of an interposition vein graft reconstruction is associated with minimal morbidity and good long-term patency.

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