title: Surgical treatment of popliteal venous aneurysms.
abstract: BACKGROUND
  Popliteal venous aneurysms (PVAs) are rare; however, they can lead to pulmonary emboli (PEs) and death. The purpose of this study was to review our institutional management of PVA.
  
  
  METHODS
  All patients with PVA undergoing intervention in our institution were identified over a 15-year period (1998-2013). A retrospective review including clinical presentation, modality of diagnosis, surgical treatment, 30-day morbidity and mortality, and follow-up are reported.
  
  
  RESULTS
  Five male and 3 female patients with PVA were identified. Mean age was 38.6 years (range, 14-65). Five patients presented with PE; 1 developed PE while on anticoagulation. Two presented with lower extremity pain. Two patients had PVA found incidentally. Diagnosis of PVA was made by duplex ultrasound (US) in 6 patients, physical examination confirmed with duplex US in 1 patient, and magnetic resonance imaging in 1 patient. Mean aneurysm size was 26 mm (range, 20-37). Four were saccular and 4 fusiform. Three PVAs contained thrombus, including 2 patients presenting with PE and 1 with calf pain. Five patients underwent aneurysmectomy with lateral venorrhaphy, and 3 patients had resection of the aneurysm with interposition vein graft. There were no operative or 30-day mortalities. Two patients with vein grafts had early postoperative complications; one developed a hematoma that required operative evacuation and one had thrombosis of the vein graft requiring thrombolysis. Mean follow-up was 26 months with 87.5% primary patency, 100% secondary patency, and no recurrences.
  
  
  CONCLUSIONS
  PVAs are rare, but can lead to significant morbidity and death. Based on this small group, aneurysmectomy with lateral venorrhaphy appears to have fewer complications compared with those treated with vein grafts. Overall, operative repair of PVA is safe and recommended in select patients with PVA.
authors.affiliation: Division of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, MN. Electronic address: jjohnst9@fairview.org.
authors.forename: Jill K
authors.initials: JK
authors.lastname: Johnstone
authors.affiliation: Division of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, MN.
authors.forename: Mark D
authors.initials: MD
authors.lastname: Fleming
authors.affiliation: Division of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, MN.
authors.forename: Peter
authors.initials: P
authors.lastname: Gloviczki
authors.affiliation: Division of Vascular and Endovascular Surgery, Mayo Clinic, Phoenix, AZ.
authors.forename: William
authors.initials: W
authors.lastname: Stone
authors.affiliation: Division of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, MN.
authors.forename: Manju
authors.initials: M
authors.lastname: Kalra
authors.affiliation: Division of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, MN.
authors.forename: Gustavo S
authors.initials: GS
authors.lastname: Oderich
authors.affiliation: Division of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, MN.
authors.forename: Audra A
authors.initials: AA
authors.lastname: Duncan
authors.affiliation: Division of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, MN.
authors.forename: Randall R
authors.initials: RR
authors.lastname: De Martino
authors.affiliation: Division of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, MN.
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Bower
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000783:Aneurysm / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010808:Physical Examination; D011152:Popliteal Vein / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D011183:Postoperative Complications / Q000601:surgery; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D012501:Saphenous Vein / Q000637:transplantation*; D013997:Time Factors; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex; D058017:Vascular Grafting / Q000009:adverse effects / Q000401:mortality; D014654:Vascular Patency; D055815:Young Adult