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ITALIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY
A Journal on Vascular and Endovascular Surgery
Giornale Italiano di Chirurgia Vascolare 2002 September;9(3):295-307
language: English, Italian
Venous aneurysms of the popliteal cavity
Marongiu G. M., Porcu P., Piredda F., Bacciu P. P.
Department and Unit of Vascular Surgery University of Sassari, Sassari
Background. We report our experience of venous aneurysms of the popliteal cavity (VAPC) and in particular popliteal vein aneurysms (PVA), which still present a number of unresolved problems, starting from their etiopathogenesis and ranging through to treatment.
Methods. Our experience of PVA is limited to the past 5 years, during which we observed 5 cases (4 sacciform aneurysms and 1 fusiform aneurysm). The other VAPC, observed over the course of some 15 years, involved the sapheno-popliteal junction (SPJ), (2 cases) and medial gemellar vein (MGV), (2 cases). In all cases diagnosis was made during phlebography for other pathologies. Surgery for PVA consisted of the avulsion of the aneurysmatic sac with direct suture of phlebotomy and was only performed in sacciform aneurysms, whereas fusiform aneurysms were monitored over time and treated with an elastic bandage. Aneurysms of the SPJ and aneurysms of MGV were removed in toto without reinstating vascular continuity. PVA surgery was associated with anticoagulating treatment for 6 months and the use of an elastic bandage for 1-2 months.
Results. After surgery PVA were followed up using colour Duplex scanning at 1, 3, 12, 24 months and a more recent check up was performed (maximum follow-up 4 years and 7 months). The popliteal axis was patent in all cases and no complications were observed (thrombosis, pulmonary embolism).
Conclusions. These results support the idea that sacciform aneurysms of the PV should always undergo surgery even if they are asymptomatic (absence of endoluminal thrombosis and pulmonary embolism). On the contrary, provided that they are asymptomatic, fusiform aneurysms should be monitored periodically. Anticoagulating treatment is essential in all cases for not less than 6 months. Other VAPC are removed during the course of saphenectomy (SPJ aneurysms) or because they may lead to pulmonary embolism (MGV aneurysms).