Lutz Hans-Joachim, Sacuiu Radu Dan, Savolainen Hannu
Department of Vascular and Endovascular Surgery, Verbundkrankenhaus Bernkastel/Wittlich, Wittlich, Germany.
Ann Vasc Surg. 2012 Jul;26(5):729.e7-9. doi: 10.1016/j.avsg.2011.11.027. Epub 2012 Apr 10.
Primary popliteal venous aneurysm is a rare condition. To date, approximately 150 cases have been reported. In the present article, we report a 59-year-old man who presented with a swelling of the left popliteal fossa. Duplex ultrasound scan revealed a saccular aneurysm of the popliteal vein, with a diameter of 2.5 × 2.5 cm. The distal part of the popliteal vein was dilated in a fusiform configuration up to 2.0 cm on both sides. The diagnosis was confirmed using magnetic resonance imaging and ascending phlebography. There was no sign of venous thrombosis. Our patient presented without any previous clinical evidence of pulmonary emboli. Surgery was deemed indicated. A traditional tangential aneurysmectomy and lateral venorrhaphy of the distal fusiform part of the popliteal lesion was performed as well as resection of the saccular part using a dorsal approach. Surgery and recovery were uneventful. The patient presented for follow-up after 6 and 12 weeks without any complaints. Duplex ultrasound scanning and ascending phlebography (only once after 12 weeks) were performed, which confirmed patency.
原发性腘静脉动脉瘤是一种罕见疾病。迄今为止,已报道约150例。在本文中,我们报告一名59岁男性,其左腘窝出现肿胀。双功超声扫描显示腘静脉囊状动脉瘤,直径为2.5×2.5厘米。腘静脉远端呈梭形扩张,两侧均达2.0厘米。通过磁共振成像和上行静脉造影确诊。无静脉血栓形成迹象。我们的患者既往无肺栓塞的临床证据。认为有手术指征。采用传统的切线动脉瘤切除术及对腘部病变远端梭形部分进行外侧静脉缝合术,并通过背侧入路切除囊状部分。手术及恢复过程顺利。患者在6周和12周后前来随访,无任何不适。进行了双功超声扫描和上行静脉造影(仅在12周后进行了一次),证实血管通畅。