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Phlebologie 2014; 43(02): 89-92
DOI: 10.12687/phleb2173-2-2014
Case report
Schattauer GmbH

Popliteal vein aneurysm: Is it necessary to apply anticoagulants after a surgery?

Case report and literature reviewAneurysma der Vena poplitea: Sollten Antikoagulanzien postoperativ eingesetzt werden?Ein Fallbericht und eine Literaturrecherche
M. Geremek
1   Wolski Hospital in Warsaw, Vascular Surgery Ward, Poland
,
M. Trochimczuk
1   Wolski Hospital in Warsaw, Vascular Surgery Ward, Poland
,
M. Janik
1   Wolski Hospital in Warsaw, Vascular Surgery Ward, Poland
,
G. Malek
2   Institute of Tuberculosis and Chest Diseases Warsaw, Poland
,
K. Ostrowski
1   Wolski Hospital in Warsaw, Vascular Surgery Ward, Poland
› Author Affiliations
Further Information

Publication History

Received: 28 October 2013

Accepted: 02 February 2014

Publication Date:
04 January 2018 (online)

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Summary

Aim: This study is intended to evaluate indications for antithrombotic therapy in patients with tangentially resected popliteal vein aneurysm.

Methods: Evaluation of the course of therapy in a patient with popliteal vein aneurysm. Literature review covered literature data published within the last decade. Studies were identified by searching Medline and PubMed databases for the following phrases: ”popliteal venous aneurysm” and ”popliteal vein aneurysm”.

Results: The case study and literature review revealed that thromboembolic risk cannot be entirely eliminated by means of tangential resection of popliteal vein aneurysm. Vein suture and residual postoperative dilatation of the popliteal vein can be considered predisposing factors to thromboembolic complications.

Conclusion: Patients with tangentially resected popliteal vein aneurysm involving vein suture can be administered oral antithrombotic therapy within three months postoperatively. Therapy extension should be made conditional on the degree of vein dilation reduction. Where the diameter at surgical site is larger than 20 mm, it appears appropriate to continue antithrombotic therapy and to repeat assessment in six months time.

Zusammenfassung

Ziel: Ziel dieser Arbeit ist die Bewertung der Indikationen für eine Antikoagulation nach operativer, tangentialer Resektion eines Aneurysmas der Vena poplitea.

Methode: Es wurde eine Verlaufsbeobachtung eines Patienten mit einem operativ versorgten Aneurysma der Vena poplitea durchgeführt. Zusätzlich wurde die, während des letzten Jahrzehnts veröffentlichte, Fachliteratur ausgewertet. Zu diesem Zweck wurde die medizinische Datenbank MEDLINE und PubMed nach den Stichworten „popliteal venous aneurysm” und „popliteal vein aneurysm” durchsucht. In die Analyse wurden 20 Artikel eingebracht, die Beschreibungen von 25 wegen eines Aneurysmas der Vena poplitea chirurgisch behandelten Patienten enthielten.

Ergebnisse: Die Fallanalyse und die Literaturauswertung haben gezeigt, dass eine tangentiale Resektion eines Aneurysmas der Vena poplitea allein das thromboembolische Risiko nicht vollständig eliminiert. Die Belas-sung einer chirurgischen Naht und das Vorhandensein einer postoperativen PopliteaRestdilatation können das Auftreten thromboembolischer Komplikationen begünstigen.

Fazit: Patienten nach einer tangentialen Resektion eines Aneurysmas mit einer Venennaht sollten im Zeitraum von drei Monaten nach der Operation orale Antikoagulation bekommen. Die Entscheidung über eine Fortsetzung der Therapie über diesen Zeitraum hinaus ist vom Grad der Reduktion der Venen-dilatation abhängig zu machen. Bei einem Vena poplitea-Durchmesser von über 20 mm auf der operierten Seite, scheint eine Ausdehnung der oralen Antikoagulation auf sechs Monate mit einer anschließenden klinischen und apparativen Bewertung angezeigt.

Keywords

Popliteal vein aneurysm - venous thromboembolism - antithrombotic therapy - tangential resection

Schlüsselwörter

Aneurysma der Vena poplitea - thromboembolische Komplikationen - Antikoagulation - tangentiale Resektion - venöses Aneurysma
 

  • References

  • 1 McDevit DT, Lohr JM, Martin KD. et al. Bilateral popliteal vein aneurysms. Ann Vasc Surg 1993; 7: 282-286.
    CrossrefPubMedGoogle Scholar
  • 2 Maleti O, Luigi M, Collura M. Aneurysmes veineux poplitès expèrience personelle. Phlebologie 1997; 50: 53-59.
    Google Scholar
  • 3 Labropouls N, Volteas S, Giannoukas A. et al. Asymptomatic popliteal vein aneurysm. Vasc Endovascular Surg 1996; 30: 453-457.
    Google Scholar
  • 4 Sessa C, Philippe N. et al. Managment of symptomatic and asymptomatic popliteal venous aneurysms: A retrospective analysis of 25 patients and review of literature. J Vasc Surg 2000; 32: 902-911.
    CrossrefPubMedGoogle Scholar
  • 5 Aldridge SC, Comerota AJ, Katz ML. et al. Popliteal venous aneurysm: Raport of two cases and review of the world literature. J Vasc Surg 1993; 18: 708-715.
    CrossrefPubMedGoogle Scholar
  • 6 Attaya H, Gloviczki P, McBane II R. Popliteal venous aneurysm. Vasc Med 2009; 14: 283-284.
    CrossrefPubMedGoogle Scholar
  • 7 Roche-Nagle G, Wooster D, Oreopoulos G. Popliteal vein aneurysm. Am J Surg 2010; 199: e5-e6.
    CrossrefPubMedGoogle Scholar
  • 8 Ekim H, Kutay V, Tuncer M. et al. Management of primary venous aneurysm. Saudi Med J 2004; 25: 303-307.
    PubMedGoogle Scholar
  • 9 Falls G, Eslami MH. Recurrance of popliteal venous aneurysm. J Vasc Surg 2010; 51: 458-460.
    CrossrefPubMedGoogle Scholar
  • 10 Nasr W, Babbitt R, Eslami MH. Popliteal Vein Aneurysm: A Case Report and Review of Literature. Vasc EndoVasc Surg 2008; 41: 551-555.
    CrossrefPubMedGoogle Scholar
  • 11 Gasparis AP, Awadallah M, Meisner RJ. et al. Recurrent Popliteal vein aneurysm. J Vasc Surg 2010; 51: 453-457.
    CrossrefPubMedGoogle Scholar
  • 12 Favoreel N, Devooghdt M, Marrannes J. et al. Popliteal venous aneurysm. JBR-BTR 2012; 95: 36
    PubMedGoogle Scholar
  • 13 Lutz HJ, Sacuiu RD, Savolainen H. Surgical Therapy of an Asymptomatic Primary Popliteal Venous Aneurysm. Ann Vasc Surg 2012; 26 (729) e7-729.e9.
    CrossrefGoogle Scholar
  • 14 Herrera LJ, Davis JW, Livesay JJ. Popliteal Vein Aneurysm Presenting as a Popliteal Mass. Tex Heart Inst J 2006; 33: 246-248.
    PubMedGoogle Scholar
  • 15 Fiori R, Chiappa R, Gaspari E. et al. A Rare Case of Popliteal Venous Aneurysm. Case Report Med 2010; 579: 256
    Google Scholar
  • 16 Christenson JT. Popliteal venous aneurysm: a report on three cases presenting with chronic venous insufficiency without embolic events. Phlebology 2007; 22: 56-59.
    CrossrefPubMedGoogle Scholar
  • 17 Tambyraja AL, Moores C, Chalmers RTA. Primary popliteal venous aneurysm. J Vasc Surg 2004; 40: 830
    CrossrefPubMedGoogle Scholar
  • 18 Akagi D, Oshiro H, Yamamoto K. et al. Popliteal venous aneurysm with repeated episodes of pulmonary embolism. Int Angio 2006; 25: 427-432.
    Google Scholar
  • 19 Velu RB, Quigley F, Barber G. Popliteal venous aneurysm. J Vasc Surg 2006; 44: 1360
    CrossrefPubMedGoogle Scholar
  • 20 Gabrielli R, Vitale S, Costanzo A. et al. Our experience of popliteal vein aneurysm. Interact CardioVasc Thorac Surg 2010; 11: 835-837.
    CrossrefPubMedGoogle Scholar
  • 21 Russel DA, Robinson GJ, Johnson BF. Popliteal Venous Aneurysm: A Rare Cause of Recurrent Pulmonary Emboli and Limb Swelling. Cardiovasc Intervent Radiol 2008; 31: 1026-1029.
    CrossrefPubMedGoogle Scholar
  • 22 Ikenouchi H, Sugishita Y, Tabei F. Pulmonary Embolism Due to Popliteal Venous Aneurysm. Circulation 2008; 117: 585-587.
    CrossrefPubMedGoogle Scholar
  • 23 Gillman LM, McGregor R, Guzman RP. Popliteal venous aneurysm and ilifemoral thrombosis. Can J Surg 2008; 51: e17-e18.
    PubMedGoogle Scholar
  • 24 Park JS, Kim SD, Park IY. et al. Popliteal Vein Aneurysm as a Source of Pulmonary Embolism: Report of a Case and Review of the World Literature. Ann Vasc Surg 2011; 25: e19-1139.e12.
    Google Scholar
  • 25 Williamson JML, Dalton RSJ, Chester JF. Popliteal Venous Aneurysm Causing Pulmonary Embolism and Paradoxical Embolistation in a Patient with Antiphospholipid Sundrome. Eur J Endovasc Surg 2008; 36: 227-229.
    CrossrefPubMedGoogle Scholar
  • 26 Cleoria G, Brancaccio G, Russo D. et al. Popliteal venous aneurysm: case report. Phlebology 2011; 26: 246-248.
    CrossrefPubMedGoogle Scholar
  • 27 van der Voort EMA, De Maseneer MGR. A giant aneurysm of the popliteal vein. Vasa 2012; 41: 229-232.
    CrossrefPubMedGoogle Scholar
  • 28 Tomko T, Maly R, Jiska S. et al. Popliteal Venous Aneurysm as a Cause of Recurrent Pulmonary Embolism. Vasc EndoVasc Surg 2013; 47: 155-158.
    CrossrefPubMedGoogle Scholar
  • 29 Maldonado-Fernandez N, Lopez-Espada C, Martinez-Gamez J. et al. Popliteal Venous Aneurysms: Results of Surgical Treatment. Ann Vasc Surg 2013; 27: 501-509.
    CrossrefPubMedGoogle Scholar
  • 30 Bergqvist D, Bjorck M, Ljungman C. Popliteal Venous Aneurysm – A Systematic Review. World J Surg 2006; 30: 273-279.
    CrossrefPubMedGoogle Scholar
  • 31 Kearon C. et al. Antithrombotic Therapy for VTE Disease. Prevention of VTE in Nonorthopedic Surgery Patients 9th ed: American College of Chest Physicans Evidence-Based Clinical Practice Guidelines. CHEST 2012; 141: e227S-e277S.
    CrossrefPubMedGoogle Scholar
  • 32 Torbicki A, Perrier A, Konstatinides S. et al. The Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC): Guidelines on the diagnosis and management of acute pulmonary embolism. European Heart Journal 2008; 29: 2276-2315.
    CrossrefPubMedGoogle Scholar