Popliteal artery entrapment syndrome Figure 1 Computed tomographic angiogram ﬁndings with left popliteal artery entrapment syndrome. Musculotendonous section and popliteal artery release was performed in all the patients. In 33 limbs (67.3%), simple release of the popliteal artery by division of the medial head of gastrocnemius or other abnormal slips of muscle and tendon were performed because the vessel remained undamaged. In 5 limbs (10.2%), the popliteal artery was reconstructed by autogenous saphenous vein (ASV) patch angioplasty with or without thromboendarterectomy (TEA) because of occlusion or irreversible ﬁbrosis of the popliteal artery. Finally, in 11 limbs (22.5%), ASV graft interposition or bypass with division of tendon in the limbs that showed irreversible ﬁbrous thickening of the affected popliteal arte- rial wall was performed. The posterior approach was pre- ferred for all the limbs, with dissection of the neurovascular bundle in the popliteal fossa, incising through any anomalous insertions or attachments involving the medial head of the gastrocnemius muscle, popliteus muscle, or other constricting bands causing compression of the popliteal vessels, unless a long vein bypass was required, whereby a medial approach Vascular Health and Risk Management 2008:4(1) was adopted. No effort was made to create any attachments of the medial head of the gastrocnemius muscle and this did not result in any disability. None of our patients had postoperative antiplatelet therapy. Results The surgical outcome was good with no intraoperative or long-term postoperative complications. 8 patients had short- term postoperative complications such as wound hematoma, wound infection, and leg swelling; these patients were man- aged conservatively. The mean hospital stay was 9.5 days (range, 3–24 days). The patients had a median follow-up of 34 months (range, 8–42 months). In regard to the method of follow-up within six postoperative months, all the patients underwent DU every three months as outpatients in order to determine patency of the vessels; the ﬁnding of postoperative DU was completely patent vessel in all the patients. After this postoperative 85