Entrapment syndrome of the popliteal vein: results of the surgical treatment

Entrapment of the popliteal vein has been rarely reported. Purpose of the present study was to evaluate the long-term results of vein decompression in the popliteal vein entrapment syndrome. Between August 1986 and June 1994, 35 patients (49 limbs) were operated on for popliteal vein entrapment syndrome at our Institution. There were 28 female and 7 male (mean age 44.5 +/- 13.5 years). Seven limbs had associated a popliteal artery entrapment syndrome. Twenty-three (49.6%) limbs presented with skin changes ascribed to venous disease. Preoperative diagnosis consisted on Doppler CW, Duplex Scan, venography and ambulatory venous pressure measurements. Surgical management consisted on the division of the anomalous structure causing entrapment. In 35 (71.4%) limbs subfascial ligation of perforating veins was associated. The patients were followed-up (mean 61 +/- 7 months) with venography and AVP. No deaths occurred and morbidity was 14.3%. Doppler CW and Duplex Scan were not accurate to diagnose the entrapment. Ambulatory venous pressure and venography accurately diagnosed the syndrome. Age and preoperative status did not affect long-term results (p = NS). Long-term operative success was negatively influenced by associated procedures for ligation of perforating veins (p < 0.03). Popliteal vein entrapment syndrome should be early diagnosed to prevent incompetence of perforating veins. Surgical treatment of cases not requiring ligation of perforating veins had a better long-term success rate. Treatment at later stages allows symptom amelioration but does not prevent the consequences of a long-standing chronic venous disease.