Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016:28:289-292.
doi: 10.1016/j.ijscr.2016.10.008. Epub 2016 Oct 8.

Aneurysmal degeneration of vein conduit used for vascular reconstruction-Case report and literature review

M J Tao  1 , W Al-Jundi  1 , G Roche-Nagle  2
Affiliations

Aneurysmal degeneration of vein conduit used for vascular reconstruction-Case report and literature review

M J Tao et al. Int J Surg Case Rep. 2016.

Abstract

Introduction: Popliteal artery aneurysms (PAA) are the most prevalent form of peripheral arterial aneurysms. Greater saphenous vein grafts and endoaneurysmorrhaphy remains the mainstay therapy for open repair of PAA. True aneurysmal degeneration of lower extremity infrainguinal autologous vein grafts are relatively rare and its etiology is not completely understood.

Case presentation: We present a case of a 57-year-old man with recurrent autologous venous graft aneurysmal dilatations following a surgical popliteal artery aneurysm repair.

Discussion: The pathogenesis of true aneurysmal graft dilatation remains speculative with possible pathogenesis including progression of underlying atherosclerosis, systemic dilating diathesis, autologous venous graft varicosities, low-grade infections and post-stenotic dilatations. Management of venous graft aneurysms should be subjected to the same criteria as other aneurysms. Diagnosis requires a high index of suspicion. The initial study of choice is duplex ultrasonography as it can diagnose the aneurysm and distinguish it from other popliteal masses, provide accurately measurements and identify thrombus within the aneurysm. Once diagnosed, surgical repair should be performed as soon as possible as graft dilatation tends to occur overtime and is typically followed by a rapid increase in size over a short period of time.

Conclusion: Aneurysmal degeneration of autologous saphenous venous graft following PAA repairs occur infrequently. Its etiology remains largely speculative. Accurate diagnosis and early surgical intervention can prevent progression of aneurysmal dilatation and minimize the potential of complications.

Keywords: Case report; Popliteal artery aneurysms; Saphenous vein grafts; Vein graft aneurysms.

PubMed Disclaimer

Figures

None
Graphical abstract
Fig. 1
Fig. 1
Aneurysmal degeneration of lower extremity autologous vein graft demonstrated on grayscale (A) and color (B) ultrasound.
Fig. 2
Fig. 2
Aneurysmal degeneration of lower extremity autologous vein graft (arrow).
Fig. 3
Fig. 3
Aneurysmal degeneration of lower extremity autologous vein graft at surgery. The aneurysm sac has been opened (arrow).
Fig. 4
Fig. 4
The aneurysmatic segment was resected and replaced by an interposition basilic vein graft (arrow).
See this image and copyright information in PMC

References

    1. Dawson I., Sie R.B., van Bockel J.H. Atherosclerotic popliteal aneurysm. Br. J. Surg. 1997;84(3):293–299. - PubMed
    1. Huang Y., Gloviczki P., Noel A.A., Sullivan T.M., Kalra M., Gullerud R.E. Early complications and long-term outcome after open surgical treatment of popliteal artery aneurysms: is exclusion with saphenous vein bypass still the gold standard? J. Vasc. Surg. 2007;45(4):706–713. discussion 713–5. - PubMed
    1. Dawson I., Sie R., van Baalen J.M., van Bockel J.H. Asymptomatic popliteal aneurysm: elective operation versus conservative follow-up. Br. J. Surg. 1994;81(10):1504–1507. - PubMed
    1. Corriere M.A., Passman M.A., Guzman R.J., Dattilo J.B., Naslund T.C. Mega-aneurysmal degeneration of a saphenous vein graft following infrainguinal bypass? A case report. Vasc. Endovasc. Surg. 2004;38(3):267–271. - PubMed
    1. Lopez M.T., Dorgham A.S., Rosas F.C., de Loma J.G. Aneurysmal degeneration of a saphenous vein graft following the repair of a popliteal aneurysm: case report and literature review? Vascular. 2012;20(5):294–298. - PubMed

LinkOut - more resources