Clinical Study Of 37 Cases Of Popliteal Vascular Entrapment Syndrome

Objective:The purposes of this study are to summarize and analysis the clinical date and evaluate outcomes following surgery in 37 cases of popliteal vascular entrapment syndrome?PVES?.Methods:A retrospective study of all patients diagnosed as PVES between July 2004 and July 2016 was performed.Patient demographic date,clinical features,imaging modalities,and surgical management were recorded.The primary outcome was patency and clinical syndromes.37 patients?44 limbs?underwent surgery.the means age at the time of surgical procedure was 37 years old.Six patients were found to have bilateral involvement.Intermittent claudication was the most frequent presenting symptom.Examination before surgery include Doppler ultrasonography,CTA,MRA and DSA.Ankle brachial index?ABI?and clinical syndrome will be contrast before and after operation.According to the outcomes of Doppler ultrasonography,CTA,MRA and DSA.Ankle brachial index?ABI?and clinical syndrome,using statistical methods evaluate outcomes following surgery to make best surgical treatment.Results:1.The 37 patients with a mean age of?37± 18?years,28 patients are male,9patient are female.Regarding PVES classification there were 7?15.9%?,12?27.2%?,20?45.5%?2?4.5%?,3?6.8%?type ?,?,?,? and ? PVES.Seven patients were found to have bilateral involvement.2.A total of 38limbs were treated with surgery.Musculotendinous division without vascular reconstruction in 9 limps;Musculotendinous division with popliteal-popliteal interposition in 17 limps;Musculotendinous division with endarterectomy and vein patch 3 in limps,Musculotendinous division and femoral-popliteal bypass with great saphenous vein in 6 limps;Simple femoral-popliteal bypass with great saphenous veins without musculotendinous division in 2 limps.3.Thirty-eight limbs were treated by surgery,of which 5 limbs had ischemic symptoms again,another 6 limbs were not treated,followed by 5 cases of limbs,4 cases had ischemic symptoms lately,and one of the cases treated by surgery in other hospital.According to the statistical analysis,patients who have surgical treatment with or without ischemic symptoms will get batter outcomes than conservative treatment?P = 0.011<0.05?.4.One patient died of PE one day after operation.Other patients' symptom of intermittent claudication,rest pain,paralysis or poikilothermia was disappeared.The average time or follow up was?43.8±37.0?months,and the ABI ascended from?0.54±0₃1?before operation to?0.87±0.23?after operation,there was a significantly difference?p<0.01?.5.Four patients with early Rutherford grade 0 were cured,and never had postoperative ischemic symptoms again;Five patients with Rutherford grade I recover well after operation.9 patients with Rutherford grade ? recover well after operation,1 patient had ischemic symptoms again;13 patients with Rutherford grade III recover well,3 patients had ischemic symptoms again,of which one patient had surgical treatment again;5 cases of patients with Rutherford grade IV patients,2 cases of which recovery well without ischemic symptoms,3 cases of which had ischemic symptoms again.According to the statistical analysis:surgical outcomes of patient with Rutherford grade 0,grade I was superior to surgical outcomes of patient with Rutherford grade IV surgery?P = 0.027<0.05?;compared with Rutherford grade IV,patients with Rutherford 0,?,? level of surgery had batter surgical results?P = 0.018<0.05?.The surgical results of Rutherford 0,?,?,and ? had a significant advantage compared with that of Rutherford IV?P = 0.027<0.05?.In the early stage of disease development,Surgical treatment is superior to the middle and late surgical results.Conclusions:PVES is an extremely important cause of non-arteriosclerotic lower extremity arterial chronic ischemia.Imaging diagnosis is an important means of diagnosing the disease.Early,active and appropriate surgical intervention will get a satisfactory outcome.