| ObjectiveThrough the collection and retrospective analysis of the clinical data of patients with popliteal artery entrapment syndrome(PAES),to analysis and discussion:1.Safety and efficacy of surgical treatment in patients with different types of PAES,evaluating the difference in surgical efficacy;2.Long-term recovery of non-surgical PAES patients after drug treatment.MethodsThe clinical data of all patients with popliteal artery trapped syndrome from July 2004 to July 2020 were collected according to the inclusion and exclusion criteria.The demographic data,clinical manifestations,lesion classification,treatment information,long-term recovery and follow-up results of the patients were recorded.All data were statistically analyzed by SPSS 23.0 statistical software,mainly focusing on the long-term patency rate of lower extremity arteries,the remission rate of lower extremity symptoms and the recovery of function of the affected limb after treatment.Results1.69 patients with PAES(92 affected limbs)were included in this study,with an average age of 39.5 ± 16.1 years.The number of cases with bilateral lesions was 23(23/92,33.3%).The main symptom of the patients was intermittent claudication(61/69 88.4%),and the average preoperative claudication distance was 240±176.6 m,of which 4 patients(5.8%)had rest pain at night.3 patients presented with lower extremity venous insufficiency,and the rest of the patients were mostly cold and numb in the lower extremities.2.According to the relationship between the popliteal artery and the surrounding tissue structure,combined with the imaging results and intraoperative findings of the patient,the clinical classification was carried out:8 limbs of type Ⅰ(8/92 8.7%);type Ⅱ(28/92 30.4%);Type Ⅲ(39/92 42.3%);Type Ⅳ(1/92 1.1%);Type Ⅴ(12/92 13.0%);Type Ⅵ(2/92 2.2%);Mixed Type(2/92,2.2%).3.A total of 68 affected limbs underwent surgical treatment.One patient(type Ⅴ)died of sudden pulmonary embolism 1 day after surgery due to antiphospholipid antibody syndrome;3 patients had delayed incision healing;Rest pain,claudication symptoms were relieved,and the total technical success rate was 100%.The ankle brachial index(ABI)was significantly higher than that before operation((0.92±0.17)VS(0.58±0.30);t=7.617;P<0.0001).The claudication distance between patients after operation was significantly longer than before((684±296.8)m VS(240±176.6);t=8.720;P<0.0001),and the 1-year primary patency rate was 81.9%.No serious complications were found in the follow-up patients,suggesting that surgery has high safety.There was no significant difference in the long-term patency rate between patients with different types of PAES through the between-group paired test(P>0.05).After drug treatment,the claudication distance in non-surgical patients was slightly longer(487.5±216.1)m than before(262.5±149.5)m(t=2.265;P<0.05);the first-stage patency rate was 56.3%.Comparing the patients in the operation group and the non-operation group,the long-term patency rate of the blood vessels in the operation group was higher than that in the non-operation group,and the difference was statistically significant(P<0.05).ConclusionThere was no significant difference in the surgical efficacy of different types of PAES patients,and the postoperative long-term patency rate was significantly higher than that of non-surgical treatment.After the diagnosis is confirmed and the general condition of the patient is assessed,surgical intervention should be performed as soon as possible.Although conservative treatment cannot completely cure PAES,it can improve the prognosis of patients by inhibiting thrombosis and reducing distal vascular embolism.Therefore,all PAES patients should be routinely used anticoagulant and antiplatelet drugs after operation,which can reduce the recurrence of thrombosis and the risk of long-term vascular embolism. |
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