Long-term outcomes after revascularization for advanced popliteal artery entrapment syndrome with segmental arterial occlusion

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.

Download Full-text

Popliteal Artery Entrapment Syndrome Presenting with Acute Limb Ischaemia: A Case Report

Case Reports in Medicine ◽

10.1155/2010/281925 ◽

2010 ◽

Vol 2010 ◽

pp. 1-3 ◽

Cited By ~ 6

Author(s):

Ramawad Soobrah ◽

Adam Nawaz ◽

Tahir Hussain

Keyword(s):

Popliteal Artery ◽

Young Patients ◽

Arterial Occlusion ◽

Rare Condition ◽

Limb Ischaemia ◽

Acute Ischaemia ◽

Entrapment Syndrome ◽

Popliteal Artery Entrapment Syndrome ◽

Acute Limb Ischaemia ◽

Popliteal Artery Entrapment

Popliteal artery entrapment syndrome (PAES) is a relatively rare condition that occurs in young patients as a result of anomalous anatomic relationships between the popliteal artery and the surrounding musculotendinous structures. Patients usually lack atherogenic risk factors and most commonly present with intermittent claudication in the early stages. In the later stages of undiagnosed PAES, acute ischaemia can occur as a result of complete arterial occlusion or embolism. Hence, early diagnosis and surgical release of the entrapment is crucial for good operative outcome and to prevent limb loss.

Download Full-text

Popliteal artery entrapment syndrome: diagnosis, management, and long-term outcome

Journal of Vascular and Interventional Radiology ◽

10.1016/j.jvir.2014.12.155 ◽

2015 ◽

Vol 26 (2) ◽

pp. S56-S57

Author(s):

G.M. Rutledge ◽

A.H. Jahromi ◽

Z. Irani ◽

R. Oklu

Keyword(s):

Popliteal Artery ◽

Term Outcome ◽

Long Term Outcome ◽

Entrapment Syndrome ◽

Popliteal Artery Entrapment Syndrome ◽

Syndrome Diagnosis ◽

Popliteal Artery Entrapment

Download Full-text

Case Report: Tibial and fibular osteochondroma as an unusual cause of popliteal artery entrapment syndrome

F1000Research ◽

10.12688/f1000research.13648.1 ◽

2018 ◽

Vol 7 ◽

pp. 198

Author(s):

Jamil Victor de Oliveira Mariúba ◽

Marcone Lima Sobreira ◽

Winston Bonetti Yoshida ◽

Eduardo Savio de Oliveira Mariúba ◽

Hamilton de Almeida Rollo ◽

...

Keyword(s):

Case Report ◽

Popliteal Artery ◽

Vascular Complications ◽

Arterial Occlusion ◽

Cold Weather ◽

Benign Tumors ◽

Entrapment Syndrome ◽

Popliteal Artery Entrapment Syndrome ◽

Popliteal Artery Entrapment ◽

History Of

Background: Osteochondroma, or osteocartilaginous exostosis, is the most common benign neoplasm of bone, and accounts for 20-50% of all benign tumors. Vascular complications associated with osteochondromas are rare, and include pseudoaneurysm formation, vessel occlusion and vessel displacement. To date, only two cases of popliteal artery entrapment syndrome (PAES) caused by an isolated fibular osteochondroma have been reported. Case Report: This report describes a unique case of PAES. A 33-year-old woman had a history of multiple osteochondroma, including of the proximal tibia and fibula on the left, diagnosed at age two years and monitored clinically by an orthopedist. The patient presented at our facility with a one-year history of a progressive intermittent claudication, left-sided toe pain and pallor in cold weather. After a complete evaluation, we diagnosed an arterial occlusion of the left popliteal artery. We tried several attempts of revascularization, by different forms, without success. The case went to amputation surgery. Conclusion: We consider this an important case because, although the association of osteochondroma and PAES is rare, physicians should consider it early to avoid acute vascular complications. Moreover, to date, we believe this is the first description of a PAES related with multiple osteochondroma.

Download Full-text

Long-term follow-up of patients with popliteal artery entrapment syndrome treated by endoluminal revascularization

VASA ◽

10.1024/0301-1526/a000027 ◽

2010 ◽

Vol 39 (2) ◽

pp. 189-195 ◽

Cited By ~ 12

Author(s):

Meier ◽

Schneider ◽

Amann-Vesti

Keyword(s):

Popliteal Artery ◽

Long Term Results ◽

Surgical Removal ◽

Popliteal Aneurysm ◽

Entrapment Syndrome ◽

Endovascular Revascularization ◽

Popliteal Artery Entrapment Syndrome ◽

Popliteal Artery Entrapment

The popliteal artery entrapment syndrome (PAES), a rare cause for leg ischemia, is usually treated by surgical removal of the compressing structure and either venous bypass or interposition graft. However, endovascular revascularization followed by surgery to release the artery has been reported as a feasible alternative. So far long-term results of this approach are not known. We report the follow-up of three patients with PAES and thrombotic occlusion of the popliteal and calf arteries treated by local lysis, percutaneous thrombembolectomy and angioplasty followed by musculotendinous dissection. One patient had an uneventful follow-up of 11 years while the second patient developed a popliteal aneurysm four months after the index procedure. In the third patient, angioplasty of a stenosis of the popliteal artery was performed after two years. However, occlusion of the artery occurred two years later due to a small popliteal aneurysm. Endovascular revascularization followed by surgical release of the artery may be a viable alternative in the treatment of PAES especially in cases with distal embolization. However, careful follow-up by duplex ultrasound is mandatory because of the high risk of reocclusion or development of a popliteal aneurysm.

Download Full-text