Treatment of Popliteal Artery Entrapment Syndrome with Occlusion or Stenosis of the Popliteal Artery
Clinical Scenario
This protocol addresses popliteal artery entrapment syndrome (PAES) in the specific situation where the affected popliteal artery presents with occlusion or stenosis. In this setting, surgical management must address both the underlying anatomical entrapment and the vascular compromise.
Key Condition
When occlusion or stenosis is present in the affected popliteal artery, musculotendinous section alone is insufficient. Revascularization of the affected artery is required in addition to the standard decompression procedure.
Treatment Approach
The surgical strategy combines musculotendinous section with revascularization of the affected popliteal artery. The choice of revascularization technique and operative approach depends on the extent of the affected arterial segment.
Full procedural details, approach selection criteria, and surgical algorithm available in the complete protocol →
Goal: Freedom from symptoms
References
DOI: 10.3400/avd.oa.13-00081
- In the presence of occlusion or stenosis, revascularization of the affected popliteal artery in addition to musculotendinous section is required.
- Conventionally, revascularization is performed via the interposition of the affected popliteal artery with a reversed saphenous vein graft.
- When the affected segment was extended beyond the adductor canal or down to the popliteal trifurcation on preoperative images, bypass surgery was performed through a medial approach.
- If a revascularization procedure is required, then the interposition of the affected popliteal artery should be performed with autologous vein grafting via a posterior approach to obtain long-term graft patency.
- The primary objective of surgical treatment for PAES is to free the patient from symptoms.
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