Halloul Z, Tautenhahn J, Weber M, Hay D, Wolff S, Meyer F
Universitätsklinikum Magdeburg, Klinik für Allgemein-, Viszeral- und Gefässchirurgie, Magdeburg, Deutschland.
Zentralbl Chir. 2010 Aug;135(4):372-4. doi: 10.1055/s-0030-1247287. Epub 2010 Aug 30.
A popliteal venous aneurysm is rare but needs to be considered a silent threat due to the risk of pulmonary embolism.
Using the report of an exemplary case, the diagnostic and therapeutic management including outcome is described. In particular, the favourable, case-adapted surgical approach of aneurysma resection and direct suture of the vascular wall because of the extraordinary aneurysma of the right popliteal vein is emphasised.
A 50-year-old woman underwent duplex ultrasonography because of pain in the right popliteal fossa, which revealed an aneurysm of the popliteal vein. The diagnosis was confirmed by phlebography. During the surgical approach, the popliteal vein was explored and the aneurysm subsequently excised. The defect in the wall of the popliteal vein was directly sutured avoiding a stenotic segment of the vein. The postoperative course was uneventful. Postoperatively, oral anticoagulation with coumarins was initiated for 6 months; follow-up investigations using duplex ultrasonography at 6 and 12 months showed a patent popliteal vein with no thrombotic changes.
According to the recommendations from the international literature, surgical approach using venorrhaphy or resection is absolutely indicated to prevent pulmonary embolism, especially in the mostly younger patients.
腘静脉动脉瘤罕见,但因其存在肺栓塞风险,需被视为一种隐匿性威胁。
通过一个典型病例报告,描述了包括治疗结果在内的诊断和治疗过程。特别强调了针对右侧腘静脉特殊动脉瘤所采取的有利的、适应病例的手术方法,即动脉瘤切除及血管壁直接缝合。
一名50岁女性因右腘窝疼痛接受了双功超声检查,结果显示腘静脉存在动脉瘤。静脉造影证实了该诊断。手术过程中,探查了腘静脉并随后切除了动脉瘤。腘静脉壁的缺损直接缝合,避免了静脉出现狭窄段。术后病程顺利。术后开始口服香豆素类抗凝药物6个月;术后6个月和12个月进行的双功超声随访检查显示,腘静脉通畅,无血栓形成变化。
根据国际文献的建议,为预防肺栓塞,尤其是对于大多数较为年轻的患者,绝对有必要采用静脉缝合或切除术的手术方法。