Diagnosis of popliteal artery entrapment syndrome with multidetector row spiral computed tomography

To evaluate the role of multidetector row spiral computed tomography in the diagnosis of popliteal artery entrapment syndrome (PAES).

Ten patients (13 limbs) were diagnosed as PAES through open surgery in Peking Union Medical College Hospital from January 2006 to December 2009, among whom three (30.0%) had both limbs involved.

Eleven limbs (84.6%) had occlusions in popliteal artery at admission. While only 15.4% of the patients were diagnosed as PAES by positional stress test, Doppler ultrasound, and arterial angiography, the disease was confirmed in all 10 patients by spiral computed tomography. As shown by inter-operative exploration, the PAES types included type 1 (n=2, 15.4%), 2(n=5, 38.5%),3 (n=4, 30.8%), and 5 (n=2, 15.4%). Two limbs underwent popliteal artery release only, 8 limbs underwent politeal artery release, thromboendarterectomy, and angioplasty with a venous or prosthetic patch, and 3 patients underwent catheter-based thrombolysis and popliteal artery release subsequently. During the follow-up (mean: 22 months; range: 4-33 months), the primary patency rate was 92.3% (12/13), the total patency rate was 100% (13/13), and the limb salvage rate was 100%.

Positional stress test, Doppler ultrasound, and arterial angiography play limited roles in the diagnosis of PAES with popliteal artery occlusion, while multidetector row spiral computed tomography is much helpful in diagnosing and typing PAES.