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病例系列:采用手术与介入相结合的治疗方法成功治疗复杂腘动脉压迫综合征患者。

A case series: patients with complicated popliteal artery entrapment syndrome successfully treated with a hybrid surgical and interventional treatment.

作者信息

Park Min Jung, Kim Hyeongsoo, Kim Do-Kyun, Jang Ji-Yong

机构信息

Department of Orthopedic Surgery, National Health Insurance Service Ilsan Hospital, Goyang-si, South Korea.

Division of Cardiology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, 100, Ilsan-ro, Ilsandong-gu, Goyang-si 10444, South Korea.

出版信息

Eur Heart J Case Rep. 2023 Aug 1;7(8):ytad362. doi: 10.1093/ehjcr/ytad362. eCollection 2023 Aug.

Abstract

BACKGROUND

Popliteal artery entrapment syndrome (PAES) is an underreported and underdiagnosed condition that affects the lower extremities. Previous case reports mainly presented young and uncomplicated PAES. Here, we report the cases of complicated PAES in middle-aged patients. Furthermore, we discuss the importance of a multidisciplinary team approach from diagnosis to treatment to obtain favourable clinical outcomes against this rare disease.

CASE SUMMARY

Two middle-aged patients presented with recent claudication and were diagnosed with popliteal artery obstruction due to a complicated PAES. At the multidisciplinary meeting, the decided treatment plan was to prioritize the gastrocnemius tendon accessory transfer and surgical thromboendarterectomy. In case the popliteal artery patency was unsatisfactory, an additional on-site percutaneous intervention was planned. Follow-up lower extremity computed tomographic angiography showed a patent popliteal artery without any claudication in both two cases.

DISCUSSION

Popliteal artery entrapment syndrome is a rare vascular disorder. Clinical suspicion and advanced imaging modalities can lead to an accurate diagnosis. A multidisciplinary team approach helps in obtaining favourable clinical results using minimally invasive hybrid surgical and interventional treatments.

摘要

背景

腘动脉受压综合征(PAES)是一种报道和诊断不足的累及下肢的疾病。既往病例报告主要呈现的是年轻且病情不复杂的PAES。在此,我们报告中年患者复杂PAES的病例。此外,我们讨论了多学科团队方法从诊断到治疗对于针对这种罕见疾病获得良好临床结果的重要性。

病例总结

两名中年患者近期出现间歇性跛行,被诊断为因复杂PAES导致的腘动脉阻塞。在多学科会议上,决定的治疗方案是优先进行腓肠肌腱辅助移位和外科血栓内膜切除术。如果腘动脉通畅情况不理想,则计划进行额外的现场经皮介入治疗。随访下肢计算机断层血管造影显示两例患者的腘动脉均通畅,且无任何间歇性跛行。

讨论

腘动脉受压综合征是一种罕见的血管疾病。临床怀疑和先进的成像方式可实现准确诊断。多学科团队方法有助于通过微创混合手术和介入治疗获得良好的临床结果。

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