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McBride SA, Rannelli LA, Cantle PM. Recurrent, life-threatening PE in the setting of popliteal vein aneurysm in pregnancy: a case report. Thromb J 2023; 21:53. [PMID: 37147712 PMCID: PMC10161411 DOI: 10.1186/s12959-023-00495-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 04/24/2023] [Indexed: 05/07/2023] Open
Abstract
BACKGROUND Popliteal vein aneurysms (PVA) are a rare clinical entity with unknown etiology that pose a significant risk for venous thromboembolic events (VTE). The current literature supports anticoagulation and operative management. There are few case reports of PVA in pregnancy. We present a unique case of a pregnant patient with recurrent pulmonary embolism (PE) in the setting of PVA with intra-aneurysmal thrombosis who ultimately underwent surgical excision. CASE PRESENTATION A previously healthy 34-year-old G2P1 at 30 weeks gestation presented to the emergency department with shortness of breath and chest pain. She was diagnosed with PE and subsequently required intensive care unit (ICU) admission and thrombolysis for a massive PE. While on a therapeutic dose of tinzaparin she had recurrence of PE in the post-partum period. She was treated with supratherapeutic tinzaparin and subsequently transitioned to warfarin. She was found to have a PVA and ultimately underwent successful PVA ligation. She remains on anticoagulation for secondary prevention of VTE. CONCLUSIONS PVA are a rare but potentially fatal source of VTE. Patients most commonly present with symptoms of PE. The risk of VTE is elevated in the pro-thrombotic states of pregnancy and the post-partum period due to both physiologic and anatomical changes. The recommended management of PVA with PE is anticoagulation and surgical resection of the aneurysm, however this can be complicated in the setting of pregnancy. We demonstrated that pregnant patients with PVA can be temporized with medical management to avoid surgical intervention during pregnancy, but require close symptom monitoring and serial imaging to reassess the PVA, with high index of suspicion for recurrent VTE. Ultimately, patients with PVA and PE should undergo surgical resection to reduce the risk of recurrence and long-term complications. The ideal duration of post-operative anticoagulation remains unclear, and should likely be decided on based on risks, benefits, values, and shared decision making with the patient and their care provider.
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Affiliation(s)
- S Ainslie McBride
- Department of Medicine, University of Calgary, Richmond Road Diagnostic and Treatment Centre, 1820 Richmond Rd SW, Calgary, AB, T2T 5C7, Canada.
| | - Luke A Rannelli
- Department of Medicine, University of Calgary, Rockyview General Hospital, 7007 14 St SW, Calgary, AB, T2V 1P9, Canada
| | - Paul M Cantle
- Department of Surgery, University of Calgary, Peter Lougheed Centre 5Th East Wing, 5940 - 3500 26th Ave NE, Calgary, AB, T1Y 6J4, Canada
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2
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Ito Y, Saito A, Shirai Y, Ishibashi K, Motomura N. Surgical treatment of symptomatic popliteal vein aneurysm with autologous saphenous vein panel graft. JOURNAL OF VASCULAR SURGERY CASES INNOVATIONS AND TECHNIQUES 2021; 7:645-648. [PMID: 34693095 PMCID: PMC8515164 DOI: 10.1016/j.jvscit.2021.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 08/15/2021] [Indexed: 11/13/2022]
Abstract
We report a vein surgery procedure for popliteal venous aneurysms (PVAs). A 73-year-old woman with a long, irregularly shaped, PVA and thrombus underwent graft replacement using a manually made triple vein panel graft. Simple bypass grafting with a saphenous vein was unsuitable because of long defects and a size mismatch. We harvested the great saphenous vein from the right thigh, divided it into three segments, anastomosed it side-by-side on the long side, and created a venous panel graft. Good graft patency was confirmed at 4 years postoperatively, and the clinical course was stable without pulmonary embolism recurrence.
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Affiliation(s)
- Yuya Ito
- Department of Cardiovascular Surgery, Toho University Sakura Medical Center, Sakura, Japan
| | - Aya Saito
- Department of Cardiovascular Surgery, Toho University Sakura Medical Center, Sakura, Japan
| | - Yuki Shirai
- Department of Cardiovascular Surgery, Toho University Sakura Medical Center, Sakura, Japan
| | - Kazuyuki Ishibashi
- Department of Cardiovascular Surgery, Toho University Sakura Medical Center, Sakura, Japan
| | - Noboru Motomura
- Department of Cardiovascular Surgery, Toho University Sakura Medical Center, Sakura, Japan
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3
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Musa J, Rahman M, Saliaj K, Siddik AB, Khadra R, Guy A, Aliu Q, Madani K, Kola I, Ceka E. Popliteal vein aneurysm in a teenager with knee swelling. Radiol Case Rep 2021; 16:1410-1419. [PMID: 33912255 PMCID: PMC8063711 DOI: 10.1016/j.radcr.2021.03.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 03/11/2021] [Accepted: 03/12/2021] [Indexed: 11/25/2022] Open
Abstract
Primitive vein popliteal aneurysms are rare and potentially fatal vascular disorders. The most dangerous complications of popliteal vein aneurysms are thromboembolic events, mainly pulmonary embolisms, a life-threatening event that requires a timely diagnosis and prompt management. As a treatable cause of recurrent pulmonary embolisms, their actual incidence is believed to be underestimated. Herein, we present a case report of a popliteal vein aneurysm in a previously healthy16-year old male, presenting with a swelling behind his left knee that causes minimal discomfort while walking. When feasible, early surgical repair of both symptomatic and asymptomatic popliteal venous aneurysms is advised, since they are associated with an ill-defined possibility of pulmonary embolism and mortality, if left untreated.
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Affiliation(s)
- Juna Musa
- Department of Surgery Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, USA
| | - Masum Rahman
- Research Fellow, Department of Neurological Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Abu Bakar Siddik
- Department of Pain Medicine, Mayo Clinic, Jacksonville, Florida, USA
| | - Ronny Khadra
- College of Coastal Georgia. Brunswick, Georgia, USA
| | - Ali Guy
- Department of Physical Medicine and Rehabilitation, New York University, School of Medicine, NYU Medical Center, New York, USA
| | - Qemajl Aliu
- Department of Internal Medicine, 'Shefqet Ndroqi' University Hospital, Tirana, Albania
| | - Kulsum Madani
- Medical Graduate, Deccan College of Medical Sciences (DCMS), Hyderabad,Telangana, India
| | - Ina Kola
- Department of Burns and Plastic Surgery, Tirana, Albania
| | - Elton Ceka
- Department of Radiology, Regional Hospital, Durres, Albania
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4
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Emmerich J, Blachier V, Fanon L, Mairesse S, Cordier C, Alsac JM. Treatment of popliteal venous aneurysms by femoral vein ligation. JOURNAL OF VASCULAR SURGERY CASES INNOVATIONS AND TECHNIQUES 2019; 5:228-231. [PMID: 31297472 PMCID: PMC6598725 DOI: 10.1016/j.jvscit.2018.11.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 11/13/2018] [Indexed: 11/05/2022]
Abstract
Popliteal venous aneurysms are highly associated with local venous thrombosis and pulmonary embolism. We propose a simple and new surgical therapy for popliteal venous aneurysm by ligation of the femoral vein. We describe the case of a woman with recurrent pulmonary embolism. Venous ultrasound examination showed a venous aneurysm of the right popliteal fossa. We proposed a ligature-section of the femoral vein just below the confluence of the great saphenous vein. After >6 years of follow-up, the patient is asymptomatic, with a completely normal life and only a small amount of edema of the right leg.
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Affiliation(s)
- Joseph Emmerich
- Department of Vascular Medicine and Cardiology, University Paris-Descartes, AP-HP, INSERM UMR 1153, Hôtel Dieu, Paris, France
| | - Vincent Blachier
- Department of Vascular Medicine and Cardiology, University Paris-Descartes, AP-HP, INSERM UMR 1153, Hôtel Dieu, Paris, France
| | - Laurie Fanon
- Department of Vascular Medicine and Cardiology, University Paris-Descartes, AP-HP, INSERM UMR 1153, Hôtel Dieu, Paris, France
| | - Sandrine Mairesse
- Department of Vascular Medicine and Cardiology, University Paris-Descartes, AP-HP, INSERM UMR 1153, Hôtel Dieu, Paris, France
| | - Clémence Cordier
- Department of Vascular Medicine and Cardiology, University Paris-Descartes, AP-HP, INSERM UMR 1153, Hôtel Dieu, Paris, France
| | - Jean-Marc Alsac
- Department of Vascular Surgery, University Paris-Descartes, AP-HP, Hôpital Européen Georges Pompidou, Paris, France
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Miyamotto M, Costa MDL, Granella VH, Angelo BZ, Corrêa de Andrade D, Raymundo CL, Moreira RCR. Popliteal vein aneurysm: report of two cases. J Vasc Bras 2018; 17:170-173. [PMID: 30377430 PMCID: PMC6205701 DOI: 10.1590/1677-5449.009717] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Venous aneurysms are rare and often diagnosed incidentally. Popliteal vein aneurysms are the most common type of venous aneurysms and have a strong association with the occurrence of deep vein thrombosis and recurrent pulmonary embolism. This article reports two cases of popliteal vein aneurysms associated with deep vein thrombosis.
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Affiliation(s)
- Marcio Miyamotto
- Pontifícia Universidade Católica do Paraná - PUC-PR, Hospital Universitário Cajuru - HUC, Serviço de Cirurgia Vascular e Endovascular, Curitiba, PR, Brasil.,Instituto VESSEL de Aperfeiçoamento Endovascular de Curitiba, Curitiba, PR, Brasil.,Hospital Nossa Senhora das Graças - HNSG, Serviço de Cirurgia Vascular e Endovascular Elias Abrão, Curitiba, PR, Brasil
| | - Marina de Lorenzo Costa
- Pontifícia Universidade Católica do Paraná - PUC-PR, Hospital Universitário Cajuru - HUC, Liga Acadêmica de Medicina Vascular - LAMEV, Curitiba, PR, Brasil
| | - Victor Hugo Granella
- Pontifícia Universidade Católica do Paraná - PUC-PR, Hospital Universitário Cajuru - HUC, Liga Acadêmica de Medicina Vascular - LAMEV, Curitiba, PR, Brasil
| | - Bruna Zimmerman Angelo
- Pontifícia Universidade Católica do Paraná - PUC-PR, Hospital Universitário Cajuru - HUC, Serviço de Cirurgia Vascular e Endovascular, Curitiba, PR, Brasil
| | - Danielle Corrêa de Andrade
- Pontifícia Universidade Católica do Paraná - PUC-PR, Hospital Universitário Cajuru - HUC, Serviço de Cirurgia Vascular e Endovascular, Curitiba, PR, Brasil
| | - Cintia Lopes Raymundo
- Pontifícia Universidade Católica do Paraná - PUC-PR, Hospital Universitário Cajuru - HUC, Serviço de Cirurgia Vascular e Endovascular, Curitiba, PR, Brasil.,Instituto VESSEL de Aperfeiçoamento Endovascular de Curitiba, Curitiba, PR, Brasil
| | - Ricardo César Rocha Moreira
- Hospital Nossa Senhora das Graças - HNSG, Serviço de Cirurgia Vascular e Endovascular Elias Abrão, Curitiba, PR, Brasil
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Warot M, Synowiec T, Kuffel B, Szwarckopf P, Micker M, Chęciński P. A rare case of a right common iliac venous aneurysm imitating a neoplastic tumour. BMC Cardiovasc Disord 2018; 18:185. [PMID: 30253742 PMCID: PMC6156856 DOI: 10.1186/s12872-018-0920-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Accepted: 09/17/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Aneurysms of the deep lower limbs veins are extremely rare. Diagnosis of such conditions may be confusing and suggest the presence of a neoplastic lesion. CASE PRESENTATION We herein report a case of a 68-year-old woman who was admitted with a large vein tumour revealed by sonography and computed tomography. A direct phlebography revealed a large venous aneurysm of the right common iliac vein with an adhering thrombus and a large collateral circulation. Anticoagulant treatment and compression with an elastic stocking were initiated because the patient refused surgical treatment. A 2-year follow-up showed no aneurysm growth or thromboembolic complications. CONCLUSIONS We show herein that conservative management can be effective and safe in cases of this rare condition.
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Affiliation(s)
- Marcin Warot
- Department of General and Vascular Surgery and Angiology, Poznan University of Medical Sciences (PUMS), 34 Dojazd St, 60-631, Poznan, Poland
| | - Tomasz Synowiec
- Department of General and Vascular Surgery and Angiology, Poznan University of Medical Sciences (PUMS), 34 Dojazd St, 60-631, Poznan, Poland
| | - Błażej Kuffel
- Department of General and Vascular Surgery and Angiology, Poznan University of Medical Sciences (PUMS), 34 Dojazd St, 60-631, Poznan, Poland.
| | - Patryk Szwarckopf
- Department of General and Vascular Surgery and Angiology, Poznan University of Medical Sciences (PUMS), 34 Dojazd St, 60-631, Poznan, Poland
| | - Maciej Micker
- Department of General and Vascular Surgery and Angiology, Poznan University of Medical Sciences (PUMS), 34 Dojazd St, 60-631, Poznan, Poland
| | - Paweł Chęciński
- Department of General and Vascular Surgery and Angiology, Poznan University of Medical Sciences (PUMS), 34 Dojazd St, 60-631, Poznan, Poland
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7
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Norimatsu T, Aramoto H. Surgical repair for popliteal venous aneurysm causing severe or recurrent pulmonary thromboembolism: three case reports. Ann Vasc Dis 2015; 8:56-8. [PMID: 25848436 DOI: 10.3400/avd.cr.14-00111] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Accepted: 01/07/2015] [Indexed: 11/13/2022] Open
Abstract
Poplitealvenous aneurysms (PVA) are associated with deep venous thrombosis and recurrentpulmonary thromboembolism (PE). We report three cases of PVA. In all three patients the first sign of PVA was acute PE; in one case, the PE was recurrent. Computed tomography and duplex ultrasonography revealed not only PE but also popliteal venous dilatation with thrombus. Surgical reconstruction was performed in each case after treatment for PE. No postoperative complications occurred, including recurrent PE. Surgical repair of PVA is safe and is a recommended treatment.
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Affiliation(s)
- Togo Norimatsu
- Department of Vascular Surgery, Sakakibara Heart Institute, Tokyo, Japan
| | - Haruo Aramoto
- Department of Vascular Surgery, Sakakibara Heart Institute, Tokyo, Japan
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8
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de Miranda JS, Damous SHB, Júnior MPF, Yoo JH, Yassushi ET, Zuardi A, Murakami AH, Birolini C, Utiyama EM. Great saphenous vein aneurysm: A differential diagnosis of femoral hernia and review. Int J Surg Case Rep 2015; 8C:154-7. [PMID: 25697400 PMCID: PMC4353965 DOI: 10.1016/j.ijscr.2015.01.041] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Revised: 01/23/2015] [Accepted: 01/25/2015] [Indexed: 11/24/2022] Open
Abstract
The rarity of these finding as a important differential diagnosis in groin and femoral hernia repair. Diagnosis made at operative field with possibility of preoperative diagnosis with duplex ultrasonography. The treatment well illustrated in figures by the simple ligation of the feeding vessel. Great review about the venous aneurysms and the treatment options.
Introduction Venous aneurysms are unusual clinical entities that might be difficult to diagnose and usually appear as an asymptomatic incidental finding on physical examination or imaging study and discovered only during the surgical exploration. They are important differential diagnosis of groin and other subcutaneous mass. Presentation of case We report a case of a 67-years-old woman who had a groin mass misdiagnosed as femoral hernia, which was subsequently diagnose as great saphena vein aneurysm in the intraoperative set and treated with ligature and resection. Discussion In conclusion, venous aneurysms of the superficial system are lesions that are important differential diagnosis of groin and other subcutaneous mass. Conclusion Diagnosis is readily available by duplex ultrasonography; however, in most cases, the diagnosis is done only in the operative field.
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Affiliation(s)
- Jocielle Santos de Miranda
- Departments of Surgery, Third Surgical Clinic Division of University of Sao Paulo Medical School and LIM-62 (Surgical pathophysiology laboratory), Rua Sapucaia, 326, Apto 221-C1, 3170-050 Sao Paulo, Sao Paulo, Brazil.
| | - Sérgio Henrique Bastos Damous
- Departments of Surgery, Third Surgical Clinic Division of University of Sao Paulo Medical School and LIM-62 (Surgical pathophysiology laboratory), Rua Sapucaia, 326, Apto 221-C1, 3170-050 Sao Paulo, Sao Paulo, Brazil
| | - Mario Paulo Faro Júnior
- Departments of Surgery, Third Surgical Clinic Division of University of Sao Paulo Medical School and LIM-62 (Surgical pathophysiology laboratory), Rua Sapucaia, 326, Apto 221-C1, 3170-050 Sao Paulo, Sao Paulo, Brazil
| | - Jin Hwan Yoo
- Departments of Surgery, Third Surgical Clinic Division of University of Sao Paulo Medical School and LIM-62 (Surgical pathophysiology laboratory), Rua Sapucaia, 326, Apto 221-C1, 3170-050 Sao Paulo, Sao Paulo, Brazil
| | - Eduardo Tanaka Yassushi
- Departments of Surgery, Third Surgical Clinic Division of University of Sao Paulo Medical School and LIM-62 (Surgical pathophysiology laboratory), Rua Sapucaia, 326, Apto 221-C1, 3170-050 Sao Paulo, Sao Paulo, Brazil
| | - Adriano Zuardi
- Departments of Surgery, Third Surgical Clinic Division of University of Sao Paulo Medical School and LIM-62 (Surgical pathophysiology laboratory), Rua Sapucaia, 326, Apto 221-C1, 3170-050 Sao Paulo, Sao Paulo, Brazil
| | - Abel Hiroshi Murakami
- Departments of Surgery, Third Surgical Clinic Division of University of Sao Paulo Medical School and LIM-62 (Surgical pathophysiology laboratory), Rua Sapucaia, 326, Apto 221-C1, 3170-050 Sao Paulo, Sao Paulo, Brazil
| | - Cláudio Birolini
- Departments of Surgery, Third Surgical Clinic Division of University of Sao Paulo Medical School and LIM-62 (Surgical pathophysiology laboratory), Rua Sapucaia, 326, Apto 221-C1, 3170-050 Sao Paulo, Sao Paulo, Brazil
| | - Edivaldo Massazo Utiyama
- Departments of Surgery, Third Surgical Clinic Division of University of Sao Paulo Medical School and LIM-62 (Surgical pathophysiology laboratory), Rua Sapucaia, 326, Apto 221-C1, 3170-050 Sao Paulo, Sao Paulo, Brazil
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9
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Sumalatha S, Souza ASD, Bhat KM, Bhat N, Hosapatna M, Kotian SR. An unusual right popliteal vein aneurysm in an adult cadaver: A case report. Australas Med J 2014; 7:260-3. [PMID: 25031648 DOI: 10.4066/amj.2014.2128] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The incidence of venous aneurysm is less than arterial aneurysms. Most are incidental findings with no major clinical significance. However, popliteal vein aneurysms (PVA) may be potentially life threatening, as they can be a source of pulmonary embolism and potentially even death. We report a case of right PVA in a 67-year-old male cadaver. Information from this case study may contribute to an improved understanding of these phenomena, including early detection of these or similar thromboembolic events.
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Affiliation(s)
- Suhani Sumalatha
- Department of Anatomy, Kasturba Medical College, Manipal University, Manipal, India
| | | | - Kumar Mr Bhat
- Department of Anatomy, Kasturba Medical College, Manipal University, Manipal, India
| | - Nandhini Bhat
- Department of Anatomy, Kasturba Medical College, Manipal University, Manipal, India
| | - Mamatha Hosapatna
- Department of Anatomy, Kasturba Medical College, Manipal University, Manipal, India
| | - Sushma R Kotian
- Department of Anatomy, Kasturba Medical College, Manipal University, Manipal, India
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10
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Popliteal venous aneurysm with deep venous thrombosis in the contralateral calf: report of a case. Surg Today 2013; 44:1966-70. [PMID: 23893160 DOI: 10.1007/s00595-013-0676-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Accepted: 05/22/2013] [Indexed: 10/26/2022]
Abstract
Although a popliteal venous aneurysm is a rare entity, it is an important cause of pulmonary embolism (PE), which is occasionally life-threatening. We herein report a case of a popliteal venous aneurysm with deep venous thrombosis (DVT) in the contralateral calf. A 65-year-old male, who presented with sudden onset palpitation and dyspnea, was transferred to our hospital. Enhanced computed tomography revealed PE and a venous aneurysm of the left popliteal vein. The popliteal venous aneurysm was saccular and had an intramural thrombus. Furthermore, duplex scanning detected DVT in the contralateral calf. The patient underwent a tangential aneurysmectomy with lateral venorraphy. The surgery and postoperative course were uneventful. The PE and calf DVT disappeared with perioperative anticoagulant therapy. It is recommended that, in the treatment of popliteal venous aneurysms, special attention should be given to the condition of the venous vessels of the contralateral leg, because this can influence the therapeutic strategy.
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11
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Donati M, Biondi A, Brancato G, Donati A, Basile F. Venous aneurysms of saphena magna: is this really a rare disease? : Comment to: A challenging hernia: primary venous aneurysm of the proximal saphenous vein. Hernia 2012; 17:115-7. [PMID: 23132637 DOI: 10.1007/s10029-012-1003-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2012] [Accepted: 10/12/2012] [Indexed: 10/27/2022]
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12
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Debnath D, Wallace S, Mylona E, Myint F. Aneurysm of antecubital vein: an unusual complication of peripheral intravenous cannulation. BMC Surg 2007; 7:9. [PMID: 17570851 PMCID: PMC1906743 DOI: 10.1186/1471-2482-7-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2006] [Accepted: 06/14/2007] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Intravenous cannulation is a very common procedure. Venous aneurysm secondary to peripheral intravenous cannulation is extremely rare. Moreover, venous aneurysm can mimic other conditions and may confuse the issue. CASE PRESENTATION We describe a case of a 45-year-old woman who was referred with the diagnosis of varicose vein of right arm. A history of intravenous cannulation at the same site was noted that raised suspicion. The swelling was compressible and turned out to be a venous aneurysm. The lesion was completely excised. Postoperative recovery was uneventful. Histology findings were in conformity with the preoperative diagnosis. CONCLUSION Caution should be exercised in diagnosing varicose vein at a site that bears a history of intravenous cannulation. The case also raises an important issue regarding consent. Should patients undergoing peripheral intravenous cannulation be warned of this rare complication?
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Affiliation(s)
- Debasish Debnath
- Department of Surgery, North Middlesex University Hospital, London, N18 1QX, UK
| | - Stuart Wallace
- Department of Surgery, North Middlesex University Hospital, London, N18 1QX, UK
| | - Evangelia Mylona
- Department of Pathology, North Middlesex University Hospital, London, N18 1QX, UK
| | - Fiona Myint
- Department of Surgery, North Middlesex University Hospital, London, N18 1QX, UK
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13
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Burnley HM, McCormick D, Hurren J, Gallagher PJ. Primary venous dissecting aneurysm arising during pregnancy: a case report and review of the literature. J Clin Pathol 2003; 56:634-5. [PMID: 12890822 PMCID: PMC1770022 DOI: 10.1136/jcp.56.8.634] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
This report describes a case of venous dissecting aneurysm presenting as a popliteal mass, in a 33 year old woman. A 1 x 1 x 0.5 cm lump developed early in the course of a second pregnancy. Primary venous aneurysms are rare vascular abnormalities that can affect either the superficial or deep veins, and have been described throughout the venous system. Most commonly found in the neck and central thoracic veins, they have also been found in visceral veins and extremities. There is a tendency for vascular disturbances to occur during pregnancy. The haemodynamic changes and hormonal milieu may be the cause of vascular alterations, which can lead to new aneurysm formation, or weakening of pre-existing aneurysms. This is the first reported case of a dissecting venous aneurysm, and has the added interest that it occurred during pregnancy.
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14
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Abstract
We herein report the rare case of a 41-year-old Japanese woman in whom a venous aneurysm in the left cephalic vein was excised under local anesthesia. Histological examination revealed significant diminution in the number and size of muscle and elastic fibers in the aneurysm wall. Conceivably, a combination of endophlebohypertrophy and a congenital focal defect of the elastic and muscle fibers might have contributed to the development of this venous aneurysm.
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Affiliation(s)
- Y Goto
- Department of Cardiovascular Surgery, Akita University, Hondo, Japan
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15
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16
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Calligaro KD, Ahmad S, Dandora R, Dougherty MJ, Savarese RP, Doerr KJ, McAffee S, DeLaurentis DA. Venous aneurysms: surgical indications and review of the literature. Surgery 1995; 117:1-6. [PMID: 7809821 DOI: 10.1016/s0039-6060(05)80222-3] [Citation(s) in RCA: 225] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND During the last 20 years we diagnosed five cases of venous aneurysm of the jugular (n = 4) and basilic (n = 1) veins. The purpose of this report was to determine the natural history and indications for surgery of venous aneurysms. METHODS Our five cases were included in an English-language literature review performed through August 1993. RESULTS In our series two aneurysms (one external jugular vein, one basilic vein) were excised for cosmetic reasons. Three internal jugular vein aneurysms were followed up for up to 4 years without complications with serial color duplex ultrasonography. Of 32 patients with abdominal venous aneurysms (18 portal, seven inferior vena cava, four superior mesenteric, two splenic, one internal iliac), 13 (41%) had major complications including five deaths. Of 31 patients with deep venous aneurysms of the extremity (29 popliteal, two common femoral), 22 (71%) had deep vein thrombosis or pulmonary embolism and in 17 recurrent deep vein thrombosis or pulmonary embolism developed when patients were treated with anticoagulation alone. CONCLUSIONS Prophylactic surgery is cautiously recommended for low-risk patients with venous aneurysms of the abdomen and strongly recommended for most patients with lower extremity deep venous aneurysms. Other venous aneurysms should be excised only if they are symptomatic, enlarging, or disfiguring.
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Affiliation(s)
- K D Calligaro
- Section of Vascular Surgery, Pennsylvania Hospital/University of Pennsylvania School of Medicine, Philadelphia
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