Popliteal Vein Aneurysm Associated with Varicose Veins, Hydrocele, and Multiple Congenital Osteomas: A Case Report and Review of the Literature

Popliteal vein aneurysms (PVAs) represent a rare form of venous aneurysms and necessitate prompt management because of their well-established risk of pulmonary embolism (PE). Herein, we report a rare case of PVA without PE, successfully treated with open surgical repair. A 27-year-old man presented to our vascular clinic with chronic pain and swelling in his left lower limb. He had a long history of facial surgeries for the removal of congenital multiple osteomas. Physical examination revealed varicosities with an abnormal distribution. Duplex ultrasound showed a left PVA measuring 2.3 cm in diameter and 4 cm in length. Open surgical excision of the PVA with lateral venorrhaphy was performed through a medial approach. Prophylactic anticoagulation was performed postoperatively. In this case, the PVA was detected, with a high degree of suspicion by the clinician, before it caused fatal PE. The patient was successfully treated with aneurysm excision and lateral venorrhaphy.

A Popliteal Vein Aneurysm Causing Pulmonary Embolism

Popliteal vein aneurysm is a very uncommon and rarely reported although potentially life-threatening disease because it can be a source of pulmonary embolism. A patient with recurrent pulmonary embolism must be checked for lower extremity venous abnormalities. Recently, newer techniques including duplex scanning, computerized tomography and magnetic resonance imaging are useful in detecting popliteal fossa venous abnormalities. However, venography is also mandatory before operating on a popliteal vein aneurysm. Several methods are useful for the surgical treatment of popliteal vein aneurysms, including aneurysmectomy with lateral venorrhaphy, aneurysmectomy with vein transposition, aneurysmectomy with vein patch, etc. Following surgery, anticoagulation therapy is widely accepted. Here in, we present a case of popliteal vein aneurysm with pulmonary embolism. This patient was a 67-year-old woman exhibiting chest pain and exertional dyspnea. Lung scan and chest CT revealed multiple pulmonary embolisms and lower extremity venography revealed a right popliteal vein aneurysm with thromboembolism. This patient underwent aneurysmectomy with lateral venorrhaphy.