Kimihiro Igari1, Norihide Sugano2, Toshifumi Kudo1, Takahiro Toyofuku1, Masatoshi Jibiki1, Yoshinori Inoue1, Takehisa Iwai3. 1. Division of Vascular and Endovascular Surgery, Department of Surgery, Tokyo Medical and Dental University, Tokyo, Japan. 2. Department of Surgery, Tokyo Metropolitan Health and Medical Treatment Corporation Ohkubo Hospital, Tokyo, Japan. 3. Tsukuba Vascular Center, Buerger Disease Research Institute, Moriya, Ibaraki, Japan.
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.
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.
Entities:
Keywords:
autogenous vein graft; intermittent claudication; medial head of the gastrocnemius muscle; popliteal artery entrapment syndrome
Authors: Sidhartha Sinha; Jon Houghton; Peter J Holt; Matt M Thompson; Ian M Loftus; Robert J Hinchliffe Journal: J Vasc Surg Date: 2011-11-23 Impact factor: 4.268