[Aneurysms of the popliteal vein; treat early]

Abstract

Background: Venous aneurysms are uncommon and of little clinical significance. However aneurysms of the popliteal vein may be a source of potentially lethal recurrent pulmonary emboli and deep venous thrombosis. This is also possible in asymptomatic aneurysms without thrombus.

Case description: A 67-year-old hairdresser saw a vascular surgeon with a swelling in the left popliteal space that was mildly painful. Further investigations revealed an aneurysm of the popliteal vein without accompanying thrombus. She underwent surgery to remove the aneurysm and maintain the patency of the popliteal vein. Postoperatively the patient was treated with oral anticoagulation therapy for 6 months. Postoperative duplex tests showed the popliteal vein to be patent and without thrombus. The patient continued to have minor oedema after a day of standing at work.

Conclusion: Aneurysms of the popliteal vein are rare and are often accidental findings during duplex examination for varicose veins. They can also present as recurrent pulmonary embolisms or deep venous thrombosis. Vascular surgery is the treatment of choice due to the risk of thrombo-embolic complications of the aneurysm, also in asymptomatic patients.