PMID- 31028851
OWN - NLM
STAT- MEDLINE
DCOM- 20190902
LR  - 20190902
IS  - 1615-5947 (Electronic)
IS  - 0890-5096 (Linking)
VI  - 59
DP  - 2019 Aug
TI  - Functional Popliteal Artery Entrapment Syndrome: A Review of Diagnosis and 
      Management.
PG  - 259-267
LID - S0890-5096(19)30243-2 [pii]
LID - 10.1016/j.avsg.2018.12.105 [doi]
AB  - BACKGROUND: Functional popliteal artery entrapment syndrome (FPAES) results from 
      hypertrophied gastrocnemius, soleus, and/or plantaris muscles, without an 
      identifiable anatomic abnormality. Historically, FPAES has been managed with 
      surgical myotomy or myomectomy. Herein, we review the literature to evaluate the 
      results of surgery along with a newer treatment (botulinum toxin A injection) for 
      this rare form of claudication. METHODS: A literature search in PubMed, Cochrane, 
      and Ovid for studies reporting incidence and management of FPAES yielded 3391 
      publications; 2804 articles were excluded based on initially established 
      exclusion criteria. Ultimately, data were extracted from six articles, from which 
      the number of patients, demographic information, preoperative workup, surgical 
      treatment details, follow-up imaging, and results of treatment were obtained. 
      RESULTS: A total of 133 patients were studied. Mean age was 26 years; 57% were 
      female, and noninvasive testing revealed bilateral findings in 39%. Treatment 
      involved surgical myotomy/myomectomy (98; five studies) and botulinum toxin 
      injection (35; two studies). Adjunctive vascular reconstruction was performed in 
      eight of the surgical cases. Patients with FPAES who underwent surgical 
      management were evaluated subjectively for symptomatic improvement, and some 
      patients had duplex ultrasounds in follow-up averaging 25.6 months. Three of 98 
      patients (3%) had recurrent symptoms, and seven (7%) underwent revision surgical 
      procedures. Complications in the surgical management group included 
      seroma/hematoma (4%, 4/98) and infection (2%, 2/98). For the botulinum toxin 
      treatment group, improvement of symptoms was achieved in 66% of patients at an 
      average follow-up time of ten months. Most patients treated with botulinum toxin 
      did not undergo imaging in follow-up. No complications were reported. 
      CONCLUSIONS: This review suggests FPAES may be treated successfully with surgical 
      myotomy/myomectomy plus adjunctive vascular reconstruction if necessary. 
      Botulinum toxin A injection may be useful as a diagnostic and therapeutic measure 
      for FPAES.
CI  - Copyright (c) 2019 Elsevier Inc. All rights reserved.
FAU - Shahi, Niti
AU  - Shahi N
AD  - Division of Vascular and Endovascular Surgery Department of Surgery Thomas 
      Jefferson University Hospitals Philadelphia, PA. Electronic address: 
      Niti.shahi@umassmemorial.org.
FAU - Arosemena, Mariano
AU  - Arosemena M
AD  - Division of Vascular and Endovascular Surgery Department of Surgery Thomas 
      Jefferson University Hospitals Philadelphia, PA.
FAU - Kwon, Jeontaik
AU  - Kwon J
AD  - Division of Vascular and Endovascular Surgery Department of Surgery Thomas 
      Jefferson University Hospitals Philadelphia, PA.
FAU - Abai, Babak
AU  - Abai B
AD  - Division of Vascular and Endovascular Surgery Department of Surgery Thomas 
      Jefferson University Hospitals Philadelphia, PA.
FAU - Salvatore, Dawn
AU  - Salvatore D
AD  - Division of Vascular and Endovascular Surgery Department of Surgery Thomas 
      Jefferson University Hospitals Philadelphia, PA.
FAU - DiMuzio, Paul
AU  - DiMuzio P
AD  - Division of Vascular and Endovascular Surgery Department of Surgery Thomas 
      Jefferson University Hospitals Philadelphia, PA.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20190424
PL  - Netherlands
TA  - Ann Vasc Surg
JT  - Annals of vascular surgery
JID - 8703941
RN  - 0 (Acetylcholine Release Inhibitors)
RN  - EC 3.4.24.69 (Botulinum Toxins, Type A)
SB  - IM
MH  - Acetylcholine Release Inhibitors/*administration & dosage/adverse effects
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Arterial Occlusive Diseases/*diagnosis/physiopathology/*therapy
MH  - Botulinum Toxins, Type A/*administration & dosage/adverse effects
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myotomy/adverse effects/*methods
MH  - *Popliteal Artery/diagnostic imaging/physiopathology
MH  - Postoperative Complications/etiology/surgery
MH  - Predictive Value of Tests
MH  - Recurrence
MH  - Risk Factors
MH  - Treatment Outcome
MH  - Young Adult
EDAT- 2019/04/28 06:00
MHDA- 2019/09/03 06:00
CRDT- 2019/04/28 06:00
PHST- 2018/10/19 00:00 [received]
PHST- 2018/12/20 00:00 [revised]
PHST- 2018/12/26 00:00 [accepted]
PHST- 2019/04/28 06:00 [pubmed]
PHST- 2019/09/03 06:00 [medline]
PHST- 2019/04/28 06:00 [entrez]
AID - S0890-5096(19)30243-2 [pii]
AID - 10.1016/j.avsg.2018.12.105 [doi]
PST - ppublish
SO  - Ann Vasc Surg. 2019 Aug;59:259-267. doi: 10.1016/j.avsg.2018.12.105. Epub 2019 
      Apr 24.