POPLITEAL ARTERY ENTRAPMENT SYNDROME - THE ROLE OF EARLY DIAGNOSIS AND TREATMENT

Background. The purpose for this study was to evaluate whether certain factors could influence arterial impairment at presentation for treat ment of popliteal artery entrapment syndrome (PAES) and whether its ea rly diagnosis could optimize long-term results. Methods. Between 1979 and 1995, 30 patients were treated for PAES at our institution. Patien ts were characterized by age, risk factors, associated diseases, preop erative symptoms, affected side, dominant limb, duration of symptoms, musculotendinous structure causing the compression, arteriographic fin ding, arterial status at presentation, type of operation, postoperativ e complications, and long-term follow-up. Results. Twenty-nine (65%) l imbs underwent musculotendinous section (MTS), 15 (33%) limbs underwen t vascular reconstruction, and 1 (2%) was surgically explored. Patient s submitted to MTS were younger (mean, 31 +/- 3 years) than patients w ho underwent vascular reconstruction (mean, 41 +/- 4 years; p < 0.05). MTS limbs had a greater number of minor symptoms compared with those that underwent vascular reconstruction (62% versus 20%; p < 0.02). Art eriogram showed that MTS limbs had a greater number of normal findings at rest when compared with limbs that underwent conventional reconstr uction (85% versus 0%; p < 0.001). No specific factors influenced the arterial status at presentation. During follow-up, treadmill examinati on revealed that MTS limbs had a better response (96%) than limbs that had undergone vascular procedures (67%; p < 0.02). MTS limbs had a be tter long-term patency rate (mean, 87 +/- 7 months) compared with limb s that were submitted to vascular reconstruction (mean, 107 +/- 8 mont hs) (95% versus 65%; p < 0.02). Conclusions. Because PAES is a progres sive disease that can create serious vascular obstructive disease and no specific factors seem to influence the degree of vascular impairmen t, the detection and treatment of PAES at an early stage permit better long-term results.