[The entrapment syndrome of the popliteal artery: diagnosis, therapy, results].

The popliteal artery entrapment syndrome is caused by an anatomical anomaly in the popliteal fossa. Mostly the popliteal artery is compressed by a faulty insertion of the medial head of the gastrocnemius muscle. The main symptom is an intermittent claudication at an early age. We review our experience with four typical cases. All patients were examined because of a unilateral sudden claudication in the calf at ages between 23 and 43 years. In two patients we could find angiographically a typical stenosis, in two others a complete occlusion of the popliteal artery. Additionally a female patient showed a 6 x 8 cm poststenotic aneurysm in the popliteal fossa. Therapeutically we restored the flow of the artery on two patients by dividing the compressing gastrocnemius muscle. As a late complication two years after the first operation one of these patients had an occlusion of popliteal artery which was bypassed by a popliteo-crural vein graft. On two patients we primary inserted a vein graft. All patients were checked 6 months till 5 years after the first operation by duplex scanning, by measurement of pressure at the ankle and by pulse volume recording at the big toe. All our postoperative examinations demonstrate patency of the repairs and the patients have very few problems.