Popliteal Artery Entrapment Syndrome: A Case Report and Review of the Literature.
Popliteal Artery Entrapment Syndrome: A Case Report and Review of the Literature.
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DOI：
10.12659/ajcr.905170
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发表时间：
2018-01-09
期刊：
影响因子：
--
通讯作者：
Cacione DG
中科院分区：
文献类型：
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作者：
Carneiro Júnior FCF;Carrijo ENDA;Araújo ST;Nakano LCU;de Amorim JE;Cacione DG
患者：女性，47例最终诊断：月国动脉压迫综合征症状：温度梯度·肢体疼痛药物治疗：-临床操作：膝上阳窝衍生-膝下阳窝内翻隐静脉移植物：外科罕见疾病阳窝动脉压迫综合征(PAES)是由于阳窝动脉和月国窝肌筋膜结构之间的异常关系引起的。最常见的症状包括锻炼时双脚和小腿间歇性疼痛，导致跛行。PAES可导致动脉血栓形成、狭窄、远端动脉血栓栓塞症或动脉瘤。PAES的治疗包括手术探查，包括筋膜切开术、肌切开术或纤维带形成切断术，以松解月国动脉。然而，在血栓闭塞的情况下，血栓内膜切除加静脉补片动脉成形术，或静脉移植动脉旁路手术可能需要。本报告描述了一例以肢体疼痛为表现的PAES病例的表现和外科治疗，并回顾了有关这种情况的文献。一位先前健康的47岁女性出现20天的左下肢突发性疼痛病史，伴随着面色苍白和膝盖以下动脉脉搏的丧失。患肢血管造影显示左侧膝上动脉闭塞，伴有动脉闭塞，提示有动脉血栓。未闭塞的右侧月国动脉的影像显示其偏向内侧。用同侧大隐静脉搭桥左侧膝上动脉至膝下动脉，缓解了患者的症状。PAES很少见，可能由于缺乏对这种情况的了解而被低估。然而，如果早期诊断，经过适当的手术治疗，预后通常是良好的。
Patient: Female, 47 Final Diagnosis: Popliteal artery entrapment syndrome Symptoms: Thermal gradient • limb pain Medication: — Clinical Procedure: Supra-genicular popliteal derivation – infragenicular popliteal with inverted parenial saphenous vein graft Specialty: Surgery Rare disease Popliteal artery entrapment syndrome (PAES) results from an anomalous relationship between the popliteal artery and the myofascial structures of the popliteal fossa. The most common presenting symptoms include intermittent pain in the feet and calves on exercise, resulting in lameness. PAES can lead to popliteal artery thrombosis, stenosis, distal arterial thromboembolism, or arterial aneurysm. The treatment of PAES includes surgical exploration with fasciotomy, myotomy, or sectioning of fibrous band formation, to release the popliteal artery. However, in cases with thrombotic occlusion, thromboendarterectomy with venous patch arterioplasty, or venous graft arterial bypass surgery may be required. This report describes the presentation and surgical management of a case of PAES presenting with limb pain and includes a review of the literature on this condition. A previously healthy 47-year-old woman presented with a 20-day history of sudden pain in the left lower limb, associated with pallor and a loss of arterial pulses below the knee. Angiography of the affected limb showed occlusion of the left supragenicular popliteal artery, with arterial occlusion, suggestive of arterial thrombus. Imaging of the right popliteal artery, which was not occluded, showed that it was medially deviated. An ipsilateral saphenous vein graft was used to bypass the left supragenicular popliteal artery to the infragenicular popliteal artery, resulting in resolution of the patient’s symptoms. PAES is rare and can be under-diagnosed, possibly due to lack of knowledge of this condition. However, if the diagnosis is made early, the prognosis is usually favorable, following appropriate surgical treatment.