Wiersema Arno M, Kievit Jur K, van Tol Eric N, Bruijninckx Cornelis M A
Westfriesgasthuis, afd. Vaatchirurgie, Hoorn, the Netherlands.
Ned Tijdschr Geneeskd. 2012;156(7):A3927.
Venous aneurysms are uncommon and of little clinical significance. However aneurysms of the popliteal vein may be a source of potentially lethal recurrent pulmonary emboli and deep venous thrombosis. This is also possible in asymptomatic aneurysms without thrombus.
A 67-year-old hairdresser saw a vascular surgeon with a swelling in the left popliteal space that was mildly painful. Further investigations revealed an aneurysm of the popliteal vein without accompanying thrombus. She underwent surgery to remove the aneurysm and maintain the patency of the popliteal vein. Postoperatively the patient was treated with oral anticoagulation therapy for 6 months. Postoperative duplex tests showed the popliteal vein to be patent and without thrombus. The patient continued to have minor oedema after a day of standing at work.
Aneurysms of the popliteal vein are rare and are often accidental findings during duplex examination for varicose veins. They can also present as recurrent pulmonary embolisms or deep venous thrombosis. Vascular surgery is the treatment of choice due to the risk of thrombo-embolic complications of the aneurysm, also in asymptomatic patients.
静脉瘤并不常见,临床意义不大。然而,腘静脉瘤可能是潜在致命性复发性肺栓塞和深静脉血栓形成的来源。在无血栓的无症状动脉瘤中也可能发生这种情况。
一名67岁的美发师因左腘窝处肿胀且伴有轻微疼痛,前来血管外科就诊。进一步检查发现腘静脉瘤,无血栓形成。她接受了手术,切除动脉瘤并保持腘静脉通畅。术后患者接受了6个月的口服抗凝治疗。术后双功超声检查显示腘静脉通畅,无血栓形成。患者工作站立一天后仍有轻微水肿。
腘静脉瘤罕见,常在静脉曲张双功超声检查时偶然发现。它们也可能表现为复发性肺栓塞或深静脉血栓形成。由于动脉瘤存在血栓栓塞并发症的风险,血管手术是首选治疗方法,无症状患者也适用。