Yamamoto Satoshi, Hoshina Katsuyuki, Hosaka Akihiro, Shigematsu Kunihiro, Watanabe Toshiaki
Department of Vascular Surgery, The University of Tokyo Hospital, Tokyo, Japan.
Department of Vascular Surgery, The University of Tokyo Hospital, Tokyo, Japan
Vascular. 2015 Oct;23(5):449-54. doi: 10.1177/1708538114560460. Epub 2014 Nov 17.
The object of the study is to determine the long-term outcomes of surgical treatment of patients with popliteal artery entrapment syndrome at a single institute. We retrospectively reviewed 19 limbs of 16 consecutive patients who underwent surgery for popliteal artery entrapment syndrome at our hospital over the past 36 years. The popliteal artery was stenotic in 11 limbs, occlusive in 7 limbs, and compressed and deviated by the medial head of the gastrocnemius muscle but not damaged in 1 limb. Six limbs were treated with autologous saphenous vein bypass, 10 with bypass or venous patch graft concomitant with musculotendinous section, and 3 limbs underwent musculotendinous section alone. The 10-year cumulative patency of the 13 limbs treated with bypass was 100%, although two of them showed occlusion at 23 and 12 years after surgery. One patient who received a venous patch graft showed occlusion 15 years after surgery. Additionally, one asymptomatic patient with an apparently non-damaged popliteal artery who received preventive musculotendinous section alone showed stenosis of the artery 2 years after musculotendinous section. In conclusion, the bypass patency observed in this study was excellent in the long term. Careful examination of popliteal artery anatomy using imaging studies is essential for selecting the appropriate surgical procedure for popliteal artery entrapment syndrome.
本研究的目的是确定在单一机构中接受手术治疗的腘动脉压迫综合征患者的长期预后。我们回顾性分析了过去36年在我院接受腘动脉压迫综合征手术的16例连续患者的19条肢体。11条肢体的腘动脉存在狭窄，7条肢体存在闭塞，1条肢体的腘动脉被腓肠肌内侧头压迫并移位但未受损。6条肢体接受了自体大隐静脉旁路移植术，10条肢体接受了旁路移植术或静脉补片移植术并同时进行了肌腱切断术，3条肢体仅接受了肌腱切断术。接受旁路移植术治疗的13条肢体的10年累积通畅率为100%，尽管其中2条肢体在术后23年和12年出现闭塞。1例接受静脉补片移植术的患者在术后15年出现闭塞。此外，1例无症状且腘动脉明显未受损的患者仅接受了预防性肌腱切断术，术后2年出现动脉狭窄。总之，本研究中观察到的旁路移植术长期通畅率良好。使用影像学检查仔细评估腘动脉解剖结构对于为腘动脉压迫综合征选择合适的手术方法至关重要。
