Özgür DAĞ, Ümit ARSLAN, Bilgehan ERKUT, Ziya YILDIZ, Mehmet TORT, Ümit HALICI, Mehmet Ali KAYĞIN, Hüsnü Kamil LİMANDAL

Our experiences with popliteal artery entrapment syndrome

Bu çalışmada, popliteal arter tuzak sendromu nedeniyle ameliyat edilen hastalara ilişkin deneyimlerimiz sunuldu.Çalışma planı: Mart 2007 - Haziran 2010 tarihleri arasında kliniğimizde popliteal arter tuzak sendromu nedeniyle ameliyat edilen 12 hasta (9 erkek, 3 kadın; ort. yaş 23.4±6.6 yıl; dağılım 16-40 yıl) retrospektif olarak incelendi. On bir hastada tek taraflı ve bir hastada iki taraflı popliteal arter tuzak sendromu vardı. Hastaların sekizinde tip 2 hastalık var iken, geri kalan hastalarda tip 3 hastalık vardı. Fizik muayenede nabızları alınamıyordu. Hastalıktan etkilenen ekstremitede ölçülen ayak bileği brakiyel indeksi 0.30 ile 0.46 arasında değişiyordu. Tanı, manyetik rezonans anjiyografi veya bilgisayarlı tomografi anjiyografi ile kondu.Bul gu lar: Manuel Doppler ultrasonografi ile popliteal arterin distalindeki akım değerlendirildi ve pulsatil akım tespit edildi. Tüm hastalarda ameliyat sonrası ayak bileği-kol indeksi 0.90 ile 0.97 arasında ölçüldü. Hastalar taburcu sonrasında birinci ve üçüncü ayda manyetik rezonans görüntüleme veya bilgisayarlı tomografi anjiyografi muayeneleri için polikliniğe çağrıldı. Sonuçlar normaldi; femoropopliteal arter baypas greftleri açıktı ve popliteal arterin trombektomi yapılan lümenleri açıktı. İskemik ülser tamamen iyileşti. Hastane mortalitesi gözlenmedi.So nuç: Çalışma bulgularımız, kladikasyon yakınması olan genç hastalarda popliteal arter tuzak sendromunun göz önünde bulundurulması gerektiğini ve bu hasta nüfusunda ayrıntılı vasküler muayenenin ayırıcı tanı ve tedavi planlaması açısından çok önemli olduğunu göstermektedir

Popliteal arter tuzak sendromu deneyimlerimiz

In this study, we aimed to present our experiences on patients undergoing surgery for popliteal artery entrapment syndrome.Methods: Between March 2007 and June 2010, 12 patients (9 males, 3 females; mean age 23.4±6.6 years; range 16 to 40 years) who underwent surgery for popliteal artery entrapment syndrome in our clinic were retrospectively analyzed. Eleven patients had unilateral and one patient had bilateral popliteal artery entrapment syndrome. Of all patients, eight had type 2 disease, while the remaining patients had type 3 disease. Physical examination revealed non-palpable pulses. The Ankle-Brachial indices of the affected extremity varied between 0.30 to 0.46. The diagnosis was based on magnetic resonance angiography or computed tomography angiography.Results: The flow of distal popliteal artery was evaluated by the manual Doppler ultrasonography and pulsatile flow was detected. Postoperative ankle-brachial indices of patients were measured between 0.90 to 0.97 values in all patients. The patients were scheduled for the outpatient clinic at one and three months after discharge for magnetic resonance imaging or computed tomography angiography examinations. The results were normal, which indicated that femoro-popliteal artery bypass grafts were patent and popliteal artery lumens at the thrombectomy sites were open. Ischemic ulcers were completely healed. There was no in-hospital mortality.Conclusion: Our study results suggest that popliteal artery entrapment syndrome should be kept in mind in young patients with complaint of claudication and a detailed vascular examination is of utmost importance for the differential diagnosis and treatment plan in this patient population

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