Surgical treatment of popliteal vein entrapment causing symptoms

Objective:To review series of cases in which surgery was used to treat popliteal vein entrapment (PVE). Methods: Between 1984 and 2001, 11 patients (all women; mean age 27.6 years; 14 limbs) underwent surgery for PVE causing calf ache, swelling, and tenderness of the popliteal fossa. Preoperative evidence of PVE included positive results on a passive dorsiflexion test, compression of the popliteal vein on ascending venography, hypertrophied or aberrant muscle in the popliteal fossa on CT scanning and elevated below-knee venous pressure. The medial or third head of the gastrocnemius muscle was partly or totally resected under the guidance of intraoperative venous pressure measurement and venography. Results: No operative complications occurred. During 3-10 years of follow-up, 57% of limbs were symptom-free, 21% were improved and 21% were unchanged. Conclusion: Treatment of PVE by resection of muscle fibres under the guidance of objective intraoperative assessments was effective in most patients.