Popliteal Artery Entrapment. Analysis of the Literature and Report of Personal Experience

A review has been made of 210 cases of popliteal artery entrapment syn drome, submitted to direct surgical therapy, from 1959 (first case reported by Hamming) through 1983. A personal experience of 14 operative procedures on 14 limbs of 11 patients is reported.

Eighteen anatomical variants producing entrapment have been identified; however, in more than 80% of the cases, the medial gastrocnemius was involved. About two-thirds of the patients were operated on with an already occluded popliteal artery, and this implied the need for some kind of reconstructive pro cedure. No reliable data on the true incidence of the disease are yet available; however, it is certainly higher than previously suspected, as witnessed by the growing number of reported cases. Extensive screening procedures could allow identification of probable cases, but a reliable diagnosis cannot be made without angiography. Surgery should be performed as a preventive measure or in case of embolic lesions such as stenosis or aneurysm. If the artery is already oc cluded, an efficient collateral network may develop and surgery should be lim ited to patients not improving with time or at risk of limb loss.