Five Year Outcomes of Surgical Treatment for Popliteal Artery Entrapment Syndrome

Lejay, Anne; Delay, Christophe; Georg, Yannick; Gærtner, S.; Ohana, Mickaël; Thaveau, Fabien; Lee, J.T.; Gény, Bernard; Chakfé, Nabil

doi:10.1016/j.ejvs.2015.12.015

Cited by 36 publications

(35 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The proportion of patients with bilateral PAES in the literature varies significantly (range, 0‐100%) with an average of about 40%, while it was 74% in our series . Various sports are practiced by patients with PAES such as running, soccer, rugby, and athletics, of which the first two are more practiced in France.…”

Section: Discussionmentioning

confidence: 58%

Presentation, diagnosis, and management of popliteal artery entrapment syndrome: 11 years of experience with 61 legs

Corneloup

Labanere

Chevalier

et al. 2017

Scandinavian Med Sci Sports

View full text Add to dashboard Cite

Popliteal artery entrapment syndrome (PAES) is still underdiagnosed yet it may significantly interfere with lifestyle, especially among young sportspeople, with symptoms like intermittent claudication. Although case reports and small case series are sometimes published, studies with larger populations are quite rare. This study summarizes our experience with PAES on 61 limbs (35 patients) over a period of 11 years, describing the demographics, the disease, and the diagnostic and therapeutic methods used with PAES patients. In a population of 327 consecutive explored symptomatic sportspersons, PAES was confirmed in 35 patients on 61 pathologic limbs. The median time with the symptoms before diagnosis was 34 months (range, 3-180 months). The mean age of patients was 30.5 years (range, 17-52 years) with 83% of males. The proportion of patients diagnosed with bilateral PAES was 74%. The main sports practiced were running (15 patients, 43%), soccer (nine patients, 26%), rugby (two patients), and athletics (two patients). Among 21 patients, intra-compartmental pressure measurements (ICP) found 18 (86%) to have an associated chronic exertional compartment syndrome (CECS). Among the patients followed up after PAES surgery, 80% were able to resume sport at a level comparable to that before the onset of pain. PAES could be sought earlier in young sportspeople who experience unexplained leg pain during exercise to diagnose the disease and avoid complications in a timely manner. Compartmental pressures should systematically be measured in the search for an associated CECS.

show abstract

Section: Discussionmentioning

confidence: 58%

Presentation, diagnosis, and management of popliteal artery entrapment syndrome: 11 years of experience with 61 legs

Corneloup

Labanere

Chevalier

et al. 2017

Scandinavian Med Sci Sports

View full text Add to dashboard Cite

show abstract

“…One study [21] reported the ABI both at rest and during stress tests; we considered the value at rest for statistical analysis. In one case, only the ABI measured during a stress test in plantar flexion was reported [25], while in six studies, the measurements were taken at rest [33,35,[39][40][41]46].…”

Section: Resultsmentioning

confidence: 99%

Ankle Brachial Index in Different Types of Popliteal Artery Entrapment Syndrome: A Systematic Review of Case Reports

Sirico

Palermi

Gambardella

et al. 2019

JCM

View full text Add to dashboard Cite

Similar to other peripheral artery diseases, vessel narrowing in popliteal artery entrapment syndrome (PAES) reduces the ankle brachial index (ABI). Since the PAES is related to several anatomical or functional variations, we sought to determine if the ABI was correlated with the type of syndrome. Through a systematic review of literature, we identified case reports and series in which the diagnosis of PAES was accompanied by ABI measurement. Twenty-seven studies included in the qualitative synthesis described 87 limbs. The most common types of the syndrome were those caused by an abnormal medial head of the gastrocnemius (type II, n = 35, 40.23%) and aberrant course of the popliteal artery (type I, n = 20, 22.99%). The variation of plantaris muscle (n = 7, 8.05%) is currently not included in the classification system. The median value of ABI was 0.87 (interquartile range (IQR) = 0.6–1.0). There were no differences among types of syndrome (F = 0.13, p = 0.72). In conclusion, despite clinical recommendations, the ABI remains underused in PAES diagnosis. No correlation was detected between the index score and type of syndrome. The cases of PAES involving structures other than the gastrocnemius or popliteus muscle suggest the need to revisit the current clinical classification system.

show abstract

“…Importantly, the long term patency rate is inversely correlated to the extent of injury to the popliteal artery, highlighting the importance of early treatment. 7 …”

Section: Discussionmentioning

confidence: 99%

“…In more complex cases, when arterial stenosis, occlusion, or aneurysm is present, saphenous vein bypass with entrapping structure release or extra-anatomical tunnelling is the gold standard, with good long term patency (83%–100%). 7 …”

Section: Introductionmentioning

confidence: 99%

Trapped by the Entrapment

Longchamp

Besson

et al. 2020

EJVES Vascular Forum

View full text Add to dashboard Cite

Introduction Popliteal entrapment syndrome results from extrinsic compression of the popliteal artery by the surrounding musculotendinous structures and is a rare cause of limb ischaemia. The purpose of this report is to highlight potential mistakes in the management of popliteal entrapment. Report In 2000, a 23 year old man underwent a popliteal to popliteal artery bypass surgery for what was initially diagnosed as a traumatic popliteal artery thrombosis. After being initially lost to follow up for 13 years, this “unspecified traumatic” thrombosis led to several inappropriate endovascular and open procedures misinterpreted as being caused by late graft failure. These included thrombectomy, aneurysmorrhaphy, polytetrafluoroethylene covered stent graft, a redo femoropopliteal bypass, and bypass thrombolysis. The diagnosis was reached 19 years after the initial surgery, when the patient underwent a redo bypass using a retrogeniculate approach. An abnormal lateral insertion of the gastrocnemius muscle medial head, and its accessory slip, constricted the artery, and also involved the popliteal vein (Type V), thus explaining previous revascularisation failures. Surgery consisted of resecting the accessory slip and the aneurysmal bypass. The artery was reconstructed with the cephalic vein. The patient was discharged on clopidogrel 75 mg, with no further complication, and a patent bypass at six months. Based on post-operative imaging (duplex ultrasound and magnetic resonance imaging), with forced plantarflexion and dorsiflexion, asymptomatic popliteal entrapment was also present on the contralateral side. Discussion The finding of an isolated popliteal artery lesion in a young individual should be considered to be caused by popliteal artery entrapment, unless proven otherwise. Definitive surgical release of the popliteal artery should be favoured over other strategies.

show abstract

Five Year Outcomes of Surgical Treatment for Popliteal Artery Entrapment Syndrome

Abstract: Long-term outcomes of surgical procedures performed for popliteal artery entrapment syndrome can be considered satisfactory.

Cited by 36 publications

References 20 publications

Presentation, diagnosis, and management of popliteal artery entrapment syndrome: 11 years of experience with 61 legs

Presentation, diagnosis, and management of popliteal artery entrapment syndrome: 11 years of experience with 61 legs

Ankle Brachial Index in Different Types of Popliteal Artery Entrapment Syndrome: A Systematic Review of Case Reports

Trapped by the Entrapment

Contact Info

Product

Resources

About