[An overview of treatment options for a rare disease, aneurysm of the popliteal vein, in connection with a case].

INTRODUCTION

Popliteal vein aneurysm is a rare, but potentially life-threatening condition that can lead to deep vein thrombosis and/or pulmonary embolism. It is often asymptomatic, but symptoms may include pain, post-thrombotic syndrome or chronic venous insufficiency. An experienced physician may be able to detect a palpable mass in the popliteal fossa. Duplex ultrasound is the first line of diagnosis. CT or MR venography play a role in the diagnosis.

OBJECTIVE

To review the international literature, explain the possible treatment options, and present our case.

CASE REPORT: A 62-year-old female patient had a recurrent pulmonary embolism while on direct-acting oral anticoagulant therapy. Duplex ultrasound and MR angiography were performed and confirmed a partially thrombosed aneurysm of the right popliteal vein. Aneurysm resection and venorrhaphy were performed as treatment. At follow-up, ultrasound showed adequate flow in the deep venous system. 6 months later, the control MR angiography showed good flow without stenosis. There were no postoperative complications. Discussion and literature review: The pathomechanism of the disease remains unclear. Treatment options are conservative therapy and/or surgical intervention, but there is no consensus regarding the therapy of symptomatic or asymptomatic cases. There is no clear statement regarding the method and duration of postoperative anticoagulant therapy.

CONCLUSION

In the case of recurrent pulmonary embolism, the possibility of a popliteal vein aneurysm should be considered. Ultrasound is a non-invasive, widely available initial diagnostic tool. In addition to conservative treatment, the possibility of surgical intervention can be considered. The surgical procedure described in our case was successful. Orv Hetil. 2023; 164(39): 1544-1549.