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A Journal on Vascular and Endovascular Surgery

Official Journal of the Italian Society of Vascular and Endovascular Surgery
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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).

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