Importanza di una diagnosi precoce per un corretto trattamento chirurgico della PAES (Sindrome da intrappolamento dell’arteria poplitea)
M. Catani 1, R. De Milito 1, I. Clementi 1, F. Romagnoli 1, L. Simonelli 1, P.N. Vardas 1, G. Manili 1, S. Capitano 1
Affiliation
Article Info
1 Dipartimento di Chirurgia Generale “Paride Stefanini”, Dipartimento di Emergenza e Accettazione Policlinico Umberto I – Roma Università degli Studi di Roma “La Sapienza”
Abstract
Popliteal artery entrapment syndrome (PAES) is an uncommon pathological entity, caused by segmental popliteal artery compression by the surrounding myofascial structures. Clinical symptoms may appear acutely, with temporary ischaemic attacks, or chronically, with concerned calf claudicatio intermittens and for 30% are bilateral. Diagnosis, besides being based on clinical objectivity (acute and deep pain to the struck limb, mainly during active plantar hyperextension) and history-taking (subject-age and lack of atherosclerosis), is based on ultrasonographic (eco-color doppler of the aortic-iliac-femural-popliteal trunks, tensiometric doppler), angio-RM, angio-CT scan and dynamic angiographic exams. Treatment, essentially, is surgical by simple freeing of the popliteal artery from surrounding myofascial structures or by autologous vein (saphenous v.) interposition grafting and patching, or bypass without vessel resection. About clinical case reported by the autors, 44-years female with left calf acute pain symptoms, cold skin by the thermotouch, hypo-paraesthesia with fifth toe cyanosis and walking inability, surgical treatment, because of precox diagnosis, consisted of simple cut of myofibrous shoot starting from medial head of the left gastrocnemious muscle and compressing popliteal artery, with clinical chart complete resolution.
Keywords
- Popliteal artery
- entrapment syndrome
- precox diagnosis
