Objective:To study the diagnosis and treatment of popliteal venous entrapment syndrome (PVES).
Methods:The clinical data of 61 patients with PVES were retrospectively analyzed. Of the patients, 39 were males and 22 females. Their ages ranged from 34 to 58 years with average age of 44.5 years. The lesions affected 31 left legs, 20 right legs and 10 bilateral legs. Twenty-five patients presented with calf swellings, hyperpigmentations and varicosities, and 36 patients presented with stasis dermatitides and calf pains including 8 cases of stasis ulcers in affected legs. The disease durations of patients ranged from 5 to 20 years. Forty-two patients were suspected to have lower extremity deep vein valve insufficiency, and 19 patients were diagnosed as varicosity of the greater saphenous vein. Ten patients had previously experienced high ligation and stripping of the great saphenous vein. Popliteal vein entrapment was suggested by B-mode Doppler ultrasound in 6 patients. All patients underwent anterograde low limb venography and the results showed stenosis ratios were more than 70% in all the patients. There were 11 cases of upper segment stenosis, 14 cases of middle segment stenosis and 36 cases of low  segment stenosis according to the venography. Popliteal vein release operation was performed in the 36 patients with severe symptoms, and the medical compression stockings were used in the remaining 25 patients with milder symptoms.
Results:The swellings and pains were lessened to varying degrees in the 25 patients undergoing conservative treatment after wearing the compression stockings. The symptoms were alleviated and venous ulcerations were resolved within 1 month after surgery in the 36 operated patients, among which 29 cases were followed up for 3 months to 5 years, 13 of them could have a normal work and life without the compression stockings, while 16 cases required intermittent use of the stockings due to mild swelling in the inner side of ankle after standing for long periods of time. Seven cases were lost to follow-up.
Conclusions:Clinical manifestations of PVES are similar to those of venous insufficiency of lower extremity and it is easy to be misdiagnosed. For severe cases of PVES,  satisfactory results can be achieved by surgical treatment.