Emre GÖK, Tolga DEMİR, Oğuz KAYIRAN, Mazlum ŞAHİN, Murat Güçlü ELEVLİ

Popliteal artery entrapment syndrome needs an interdisciplinary approach

Bu çalışmada popliteal arter tuzak sendromuna ilişkin uzun dönem deneyimlerimiz bildirildi ve disiplinlerarası yaklaşımın önemi vurgulandı.Çalışmaplanı:Ocak 1994 - Aralık 2014 tarihleri arasında 21 hastanın (17 erkek, 4 kadın; ort. yaş 26.14 yıl; dağılım 17-35 yıl) toplam 23 ekstremitesine popliteal arter tuzak sendromu tanısı konuldu. Tüm hastalara popliteal arterin cerrahi dekompresyonu uygulandı. Tip 1 ve 2 popliteal arter tuzak sendromlu hastalara safen ven ile ven greft interpozisyonu yapıldı. Tip 3, 4 ve 6 popliteal arter tuzak sendromlu hastalara gastroknemius kası medial başının kas ve tendon rezeksiyonundan sonra ven greft interpozisyonu uygulandı.Bul gu lar: Ortalama takip süresi 120.5±59.0 ay idi. İki ekstremiteye yeniden girişim uygulanması gerekti. Genel greft açıklık oranları birinci ve beşinci yılda sırasıyla %91.3 ve %82.6 idi. Hastaların büyük bir çoğunluğu başlangıçta kalp damar cerrahisi kliniğine başvurdu; ancak sekiz hasta diğer polikliniklere başvurdu ve takiben konsülte edildi.So nuç: Popliteal arter tuzak sendromlu hastalara uygun tedavinin kısa sürede sağlanabilmesi için erken ve doğru tanı konulmalıdır. Bu nedenle, farklı branşların çeşitli polikliniklerine alt ekstremite kladikasyonu ile başvuran hastaları tedavi eden hekim, olağandışı klinik seyir olsa dahi, popliteal arter tuzak sendromu açısından dikkatli olmalıdır

Popliteal arter tuzak sendromu disiplinlerarası bir yaklaşım gerektirir

In this study, we report our long-term experiences of popliteal artery entrapment syndrome and to highlight the importance of an interdisciplinary approach.Methods: Between January 1994 and December 2014, popliteal artery entrapment syndrome was diagnosed in a total of 23 limbs of 21 patients (17 males, 4 females; mean age 26.14 years; range 17 to 35 years). All patients underwent surgical decompression of the popliteal artery. Interposition vein graft from the saphenous vein was performed on the patients with type 1 and 2 popliteal artery entrapment syndrome. Interpositional vein grafting after musculotendinous resection of the medial head of gastrocnemius muscle was carried out in the patients with type 3, 4, and 6 popliteal artery entrapment syndrome.Results: The mean follow-up was 120.5±59.0 (range, 38 to 218) months. Re-exploration was required in two limbs. Overall primary graft patency rates at one and five years were 91.3% and 82.6%, respectively. Initially, the vast majority of the patients were admitted to cardiovascular surgery outpatient clinics; however, eight patients applied to the other outpatient clinics and were subsequently consulted.Conclusion: Early and accurate diagnosis should be settled for the patients with popliteal artery entrapment syndrome to ensure an appropriate management as soon as possible. Therefore, the referral of the patients with lower extremity claudication to various outpatient clinics from different specialties should alert the treating physician for popliteal artery entrapment syndrome, even in unusual presentations

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