title: Popliteal venous aneurysms: characteristics, management strategies, and clinical outcomes--a modern single-center series.
abstract: BACKGROUND
  Popliteal vein aneurysm (PVA) may be an incidental finding on imaging, but often presents in the context of acute venous thromboembolism (VTE). The role of anticoagulation with or without surgical excision versus expectant management is ill defined.
  
  
  METHODS
  In this single-center, retrospective, cohort study, patient records from January 2002 to December 2013 were queried for terminology consistent with PVA. Demographic data and clinical outcomes were extracted via chart review.
  
  
  RESULTS
  A total of 21 patients with PVA were identified (57% male). Mean follow-up was 38 ± 31 months. Mean PVA diameter was 2.5 ± 1.1 cm; 67% were saccular (with the remainder being fusiform), 19% contained thrombus, 67% were left sided, and bilateral PVA was present in 24% of cases. At the time of PVA diagnosis, 14% had pulmonary embolism. Treatment consisted of observation only (62%), anticoagulation (19%), surgery (5%), or both anticoagulation and surgery (14%). There were no recurrences of VTE once treated, although there was 1 acute deep venous thrombosis in a patient who was managed conservatively. Two patients had recurrent PVA after surgery, and there were 2 surgical complications (transient foot drop and hematoma).
  
  
  CONCLUSIONS
  PVA is associated with VTE. Based on our series, it is unclear if incidentally discovered PVA (without VTE) warrants treatment with anticoagulation and/or surgical repair. Further multicenter studies are needed to establish the indications for safety and durability of surgery.
authors.affiliation: Institute for Heart, Vascular and Stroke Care, Massachusetts General Hospital and Harvard Medical School, Boston, MA.
authors.forename: Cameron W
authors.initials: CW
authors.lastname: Donaldson
authors.affiliation: Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA.
authors.forename: Rahmi
authors.initials: R
authors.lastname: Oklu
authors.affiliation: Institute for Heart, Vascular and Stroke Care, Massachusetts General Hospital and Harvard Medical School, Boston, MA.
authors.forename: Michael T
authors.initials: MT
authors.lastname: Watkins
authors.affiliation: Division of Vascular Surgery, MetroWest Medical Center, Framingham, MA.
authors.forename: Magruder C
authors.initials: MC
authors.lastname: Donaldson
authors.affiliation: Institute for Heart, Vascular and Stroke Care, Massachusetts General Hospital and Harvard Medical School, Boston, MA.
authors.forename: Farhad
authors.initials: F
authors.lastname: Abtahian
authors.affiliation: Institute for Heart, Vascular and Stroke Care, Massachusetts General Hospital and Harvard Medical School, Boston, MA.
authors.forename: Robert M
authors.initials: RM
authors.lastname: Schainfeld
authors.affiliation: Institute for Heart, Vascular and Stroke Care, Massachusetts General Hospital and Harvard Medical School, Boston, MA.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Jaff
authors.affiliation: Institute for Heart, Vascular and Stroke Care, Massachusetts General Hospital and Harvard Medical School, Boston, MA. Electronic address: iweinberg@mgh.harvard.edu.
authors.forename: Ido
authors.initials: I
authors.lastname: Weinberg
mesh_terms: D000328:Adult; D000465:Algorithms; D000783:Aneurysm / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D000925:Anticoagulants / Q000627:therapeutic use; D003952:Diagnostic Imaging; D019468:Disease Management; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011152:Popliteal Vein; D011183:Postoperative Complications; D011655:Pulmonary Embolism / Q000209:etiology; D012008:Recurrence; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures
chemical_list: D000925:Anticoagulants