Popliteal venous aneurysm causing pulmonary embolism and paradoxical embolisation in a patient with antiphospholipid syndrome.
BACKGROUND
Popliteal venous aneurysms are rare and can cause recurrent pulmonary emboli despite adequate anticoagulation.


METHODS
A 43-year old patient with known antiphospholipid syndrome developed an extensive pulmonary embolus and ischaemic stroke despite anticoagulation. Duplex ultrasound confirmed a right popliteal venous aneurysm containing non-adherent multi-layered thrombus. At operation an 8 cm x 5 cm true aneurysm of the popliteal vein was excised. A postoperative echocardiogram revealed a patent foramen ovale.


CONCLUSIONS
This case is unusual as the patient suffered a paradoxical embolism due to his patent foramen ovale. Although antiphospholipid syndrome is associated with venous thrombosis, this is usually prevented by therapeutic anticoagulation.
Williamson
J M L
JML
Taunton and Somerset Hospital, Taunton, UK. Electronic address: jmlw@doctors.org.uk.
Dalton
R S J
RSJ
Taunton and Somerset Hospital, Taunton, UK.
Chester
J F
JF
Taunton and Somerset Hospital, Taunton, UK.
D000328:Adult; D000783:Aneurysm / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D000925:Anticoagulants / Q000627:therapeutic use; D016736:Antiphospholipid Syndrome / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy; D002545:Brain Ischemia / Q000150:complications / Q000209:etiology; D019320:Embolism, Paradoxical / Q000000981:diagnostic imaging / Q000209:etiology*; D054092:Foramen Ovale, Patent / Q000150:complications* / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D011152:Popliteal Vein / Q000000981:diagnostic imaging / Q000601:surgery; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging / Q000209:etiology*; D020521:Stroke / Q000209:etiology; D016896:Treatment Outcome; D014463:Ultrasonography; D014656:Vascular Surgical Procedures
D000925:Anticoagulants