Popliteal Artery Entrapment Syndrome: Surgical Management and Long-Term Outcomes

Abstract

Background

Popliteal artery entrapment syndrome (PAES) is a rare vascular condition resulting from abnormal anatomical relationships between the popliteal artery and surrounding musculoskeletal structures, often causing limb ischemia. This study presents a case series of PAES patients treated surgically at a single academic center in Chile.

Methods

A retrospective review was performed on patients diagnosed with PAES from January 2012 to December 2023. Data included demographics, symptoms, diagnostic modalities, PAES type, limb involvement, surgical approach, and outcomes. All patients underwent pulse volume recordings with dynamic maneuvers and confirmatory imaging. Follow-up was conducted regularly, and data were analyzed using SPSS v25.

Results

Twelve patients (83.3% male) with a median age of 40 years (range: 22-63) and 13 affected limbs were treated. Intermittent claudication was the most common symptom (58.3%), followed by critical (25.0%) and acute limb ischemia (16.4%). Imaging confirmed PAES in all cases, predominantly type I (46.1%) and type III (38.4%). All patients underwent surgical decompression, and 46.1% required arterial revascularization. Postoperative complications occurred in 16.6%, and median hospital stay was 2.5 days (range: 1-7). Median follow-up of was 70.5 months (range: 12-105), primary patency rate was 92.3%, and 83.3% of patients remained asymptomatic during follow-up.

Conclusion

Surgical treatment of PAES is safe and effective, offering favorable mid-term outcomes with low morbidity. Early diagnosis and a multidisciplinary approach are essential to prevent irreversible arterial injury and optimize long-term results.