Popliteal venous aneurysm: a report on three cases presenting with chronic venous insufficiency without embolic events.
OBJECTIVE
Popliteal venous aneurysms (PVA) are rare, but represent a significant potential source of thromboembolus. Most often the patients present with pulmonary embolism, which can also be detected in patients presenting with chronic venous insufficiency.


METHODS
Three patients without any clinical evidence of pulmonary emboli were diagnosed by venous duplex scanning during workup for superficial venous insufficiency. None of the PVAs contained thrombus. The mean diameter of the aneurysm was 30 mm. Surgery included tangential aneurysmectomy and lateral venorrhaphy.


RESULTS
None of the patients had evidence of pulmonary embolism, and there were no postoperative deep venous thromboses diagnosed. All patients received anticoagulation therapy for three months postoperatively, and patency was confirmed by duplex scanning during follow-up four, nine and 12 months after surgery.


CONCLUSIONS
It is recommended that PVAs should be ruled out in patients undergoing workup for chronic venous insufficiency, even in the absence of embolic events. A good quality venous duplex scanning is sufficient for diagnosis and treatment. Surgical treatment of PVAs is advocated. Tangential aneurysmectomy with lateral venorrhaphy is the surgical technique of choice. It is a safe procedure with a low complication rate.
Christenson
J T
JT
Venous Surgery Centre, Department of Cardiovascular Surgery, University Hospital of Geneva, Geneva, Switzerland. jan.christenson@hcuge.ch
D000328:Adult; D000783:Aneurysm / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D000925:Anticoagulants / Q000627:therapeutic use; D002908:Chronic Disease; D006801:Humans; D008297:Male; D008875:Middle Aged; D011152:Popliteal Vein; D011655:Pulmonary Embolism / Q000209:etiology*; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex; D014656:Vascular Surgical Procedures; D014689:Venous Insufficiency / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy
D000925:Anticoagulants