Incidence, diagnosis and treatment of popliteal artery entrapment syndrome in current vascular practice in Japan

• Published in: Cardiovascular intervention and therapeutics 2021-10, Vol.36 (4), p.506-513
• Main Authors: Fujimura, Naoki, Hosokawa, Kyousuke, Obara, Hideaki, Igari, Kimihiro, Akamatsu, Daijirou, Matsumoto, Hidetoshi, Asami, Atsunori, Shibutani, Shintaro, Akiyoshi, Takurin, Nunokawa, Masao, Harada, Hirohisa, Inoue, Kyozo, Koya, Atsuhiro, Furuyama, Tadashi, Sagara, Daisuke, Shintani, Tsunehiro, Yamaoka, Terutoshi, Akiyama, Yoshinobu, Inoue, Yoshinori, Hoshina, Katsuyuki
• Format: Article
• Language: English
• Subjects: Cardiology; Interventional Radiology; Medicine; Medicine & Public Health; Original Article
• ISSN: 1868-4300; 1868-4297
• DOI: 10.1007/s12928-020-00710-1

Few data regarding popliteal artery entrapment syndrome (PAES) is available in Japan. In this study, we investigated incidence, diagnosis and treatment of PAES in current vascular practice. A retrospective analysis of all patients with PAES visiting 31 participating institutes between 2003 and 2015 was conducted. Thirty-five limbs (28 patients) were identified during the 13-year study period, and the incidence of PAES was 0.12% of all peripheral artery disease cases revascularized. Mean age was 32.0 ± 16.9 years old, and 60 and more years old was 10.7%. Also, 92.9% were male and 39.3% were athletes. Most frequent initial symptoms were intermittent claudication in 23 limbs (65.7%); 4 limbs (11.4%) had chronic limb-threatening ischemia. CT scan was most frequently (94.3%) used for the diagnostic imaging followed by MRI (45.7%) and duplex ultrasound (45.7%). Stress test such as dorsal flexion during duplex ultrasound was used only in 28.6%. Thirty-two limbs (91.4%) received surgical treatment, including 23 arterial reconstructions (71.9%); there were no major perioperative complications. All patients achieved improvement of their symptoms, and the average ankle brachial index increased from 0.69 ± 0.22 to 1.00 ± 0.14 post-surgery. The average postoperative follow-up period was 26.0 months with only one reintervention during the follow-up. In conclusion, PAES was a rare condition and traditional surgical treatment was solid. However, given a broad spectrum of clinical feature of PAES and less usage of diagnostic duplex ultrasound with stress test, there might be a miss- or delayed diagnosis of PAES even in the current vascular practice.