Buscar en
Cirugía Española (English Edition)
Toda la web
Inicio Cirugía Española (English Edition) Surgical Treatment of Popliteal Venous Aneurysm in a Young Patient
Journal Information
Vol. 96. Issue 8.
Pages 517-518 (October 2018)
Vol. 96. Issue 8.
Pages 517-518 (October 2018)
Scientific letter
DOI: 10.1016/j.cireng.2018.09.001
Full text access
Surgical Treatment of Popliteal Venous Aneurysm in a Young Patient
Tratamiento quirúrgico de un aneurisma venoso poplíteo en paciente joven
Visits
...
Emiliano Cano-Triguerosa,b,
Corresponding author
emilianocanotrigueros@gmail.com

Corresponding author.
, Romina Díaz-Serranoa
a Servicio de Angiología y Cirugía Vascular, Hospital Universitario Morales Meseguer, Murcia, Spain
b Departamento de Cirugía, Facultad de Medicina, Universidad de Murcia, Murcia, Spain
Article information
Full Text
Bibliography
Download PDF
Statistics
Figures (1)
Full Text

Popliteal venous aneurysms are a rare disease of uncertain etiology that can present with serious complications, such as deep vein thrombosis and pulmonary embolism. We present the case of a 42-year-old man who worked on a truck trailer assembly line placing screws while in a squatting position, involving repeated flexion and extension of the knees (greater force and load on the right side as he was right-handed) for 8h/day. The patient consulted with our department due to a painful tumor in the right popliteal fossa. On physical examination, a soft, non-pulsatile mass was observed; the remaining vascular examination was normal. Doppler ultrasound and venous MR angiography revealed a saccular popliteal venous aneurysm measuring 2.7×3.4cm, with no signs of thrombosis (Fig. 1A). No muscle, ligament or tendon anomalies were observed in the popliteal fossa or in the adductor canal. We indicated surgery, which was performed with the patient in prone decubitus, using a bayonet incision and under systemic heparinization, dissection of the aneurysm, tangential aneurysmectomy and lateral venorrhaphy of the popliteal vein (Fig. 1B–D). The patient was discharged 48h later with no complications and prescribed treatment with low molecular weight heparin for 3 months and elastic compression, as well as a subsequent dose of 100mg of ASA. The pathology study reported hypertrophy and generalized fibrosis of the vessel wall. After 18 months of follow-up, the patient presented no complications, with permeability of the vascular reconstruction and no recurrence of the venous dilatation on the ultrasound study.

Fig. 1.

(A) Popliteal venous aneurysm on magnetic resonance angiography; (B) intra-operative image of the venous aneurysm; (C) detail of open venous aneurysm; (D) result after tangential aneurysmectomy with lateral venorrhaphy.

(0.49MB).

Popliteal venous aneurysms are a rare disease of uncertain etiology, which can present with serious complications such as deep vein thrombosis and pulmonary embolism. A popliteal venous aneurysm is defined by a popliteal vein>20mm in diameter. In the majority of published cases, the most frequent type is saccular. Most cases present with symptoms of pulmonary embolism or are discovered incidentally; very rarely is there a painful popliteal mass, as in the case of our patient. Since pulmonary embolisms and death have been reported even in patients without thrombi, surgical excision is also recommended in asymptomatic patients.1–3 In addition, in patients with pulmonary embolism with no risk factors or a clear source of emboli, popliteal venous aneurysm should be ruled out.3 The recommended and most frequently performed technique is tangential aneurysmectomy with lateral venorrhaphy because it has fewer associated complications.2 Currently, endovascular treatment is not recommended.3 The etiopathogenesis of popliteal venous aneurysms is uncertain, with the possible intervention of a combination of mechanical, trauma, inflammatory, hemodynamic or congenital disease factors.4 We cannot confirm that repeated trauma to the right popliteal vein due to the position and movements of our patient while at work were the cause of his popliteal venous aneurysm, but, along with genetic predisposition, this may have been a contributing factor.

We have found no reports in the literature of popliteal venous aneurysms in patients performing repeated and continuous movements and positions in the workplace that may cause compressive trauma to the popliteal vein.

References
[1]
C. Sessa, P. Nicolini, M. Perrin, I. Farah, J.L. Magne, H. Guidicelli.
Management of symptomatic and asymptomatic popliteal venous aneurysms: a retrospective analysis of 25 patients and review of the literature.
J Vasc Surg, 32 (2000), pp. 902-912
[2]
J.K. Johnstone, M.D. Fleming, P. Gloviczki, W. Stone, M. Kalra, G.S. Oderich, et al.
Surgical treatment of popliteal venous aneurysm.
Ann Vasc Surg, 29 (2015), pp. 1084-1089
[3]
A. Sandstrom, A. Reynolds, P. Jha.
Popliteal vein aneurysm: a rare cause of pulmonary emboli.
Ann Vasc Surg, 38 (2017), pp. 315e15-315e17
[4]
S.C. Aldridge, A.J. Comerota, M.L. Katz, J.H. Wolk, B.I. Goldman, J.V. White.
Popliteal venous aneurysm: report of two cases and review of the world literature.
J Vasc Surg, 18 (1993), pp. 708-715

Please cite this article as: Cano-Trigueros E, Díaz-Serrano R. Tratamiento quirúrgico de aneurisma venoso poplíteo en paciente joven. Cir Esp. 2018;96:517–518.

Copyright © 2018. AEC
Article options
Tools
es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos

es en pt
Política de cookies Cookies policy Política de cookies
Utilizamos cookies propias y de terceros para mejorar nuestros servicios y mostrarle publicidad relacionada con sus preferencias mediante el análisis de sus hábitos de navegación. Si continua navegando, consideramos que acepta su uso. Puede cambiar la configuración u obtener más información aquí. To improve our services and products, we use "cookies" (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here. Utilizamos cookies próprios e de terceiros para melhorar nossos serviços e mostrar publicidade relacionada às suas preferências, analisando seus hábitos de navegação. Se continuar a navegar, consideramos que aceita o seu uso. Você pode alterar a configuração ou obter mais informações aqui.