Dallatana R, Barbetta I, Settembrini A, Casazza F, Boeri R, Carmo M, Mazzaccaro D, Settembrini P G
Division of Vascular Surgery, Università degli Studi di Milano-Ospedale San Carlo Borromeo, Milano, Italy.
Phlebology. 2013 Jun;28(4):219-22. doi: 10.1258/phleb.2012.011120. Epub 2013 May 6.
The popliteal vein is the most frequent site of venous aneurysm. Surgical treatment is indicated above a 2.5 cm diameter to prevent complications, notably deep venous thrombosis and pulmonary embolism (PE). Here we report a case of recurrent episodes of severe PE, leading to cardio-circulatory shock caused by a popliteal vein aneurysm (PVA) despite oral anticoagulant therapy. When surgical correction of the aneurysm was performed, we found an ulcerative lesion in the inner aspect of the vein that was acting as a 'thrombogenic focus' inside the aneurysm. An accurate inspection of the intimal wall is always important during surgery of PVA, particularly when tangential resection is performed.
腘静脉是静脉瘤最常见的发生部位。直径超过2.5厘米时建议进行手术治疗，以预防并发症，尤其是深静脉血栓形成和肺栓塞（PE）。在此，我们报告一例尽管接受了口服抗凝治疗，但仍因腘静脉瘤（PVA）反复发生严重肺栓塞，导致心循环休克的病例。在对动脉瘤进行手术矫正时，我们在静脉内侧发现了一个溃疡性病变，该病变在动脉瘤内充当“血栓形成灶”。在PVA手术过程中，对内膜壁进行精确检查始终很重要，尤其是在进行切线切除时。
