Outcomes of Surgical Decompression for Functional Popliteal Artery Entrapment Syndrome

Area of Science:

• Vascular Surgery
• Orthopedic Surgery
• Sports Medicine

Background:

• Functional popliteal artery entrapment syndrome (FPAES) is a rare cause of claudication in young females.
• Optimal diagnostic and treatment strategies for FPAES remain undefined.

Purpose of the Study:

• To evaluate the institutional experience with surgical decompression for FPAES.
• To analyze preoperative imaging, surgical approaches, reintervention rates, and outcomes.

Main Methods:

• Retrospective review of 66 patients (109 limbs) undergoing FPAES decompression (2010-2024).
• Analysis of preoperative imaging (MRI, ultrasound, angiogram), surgical approach (medial vs. posterior), and follow-up data.
• Evaluation of symptomatic improvement, recurrence, and reintervention rates.

Main Results:

• 80.3% of patients were female, with a mean age of 25 years.
• Initial symptomatic improvement occurred in 81.0% of limbs; 14.1% experienced recurrence.
• Redo decompression had a lower success rate (42.9%) compared to initial surgery (78.9%).

Conclusions:

• Surgical decompression is effective for selected FPAES patients.
• Persistent or recurrent symptoms necessitate further research into patient selection and multimodal testing.
• A multidisciplinary approach is crucial for optimizing FPAES treatment outcomes.