Vroegindeweij L H P, van Hove P D, Kruimer J W H, van Houten A A, Akkersdijk G P
Maasstad Ziekenhuis, Rotterdam.
Ned Tijdschr Geneeskd. 2016;160:A9722.
Popliteal venous aneurysms are very rare, but when left untreated they can lead to severe and recurrent pulmonary embolism.
A 35-year-old man was referred to the outpatients' vascular clinic for additional diagnostics of a swelling just above the back of his right knee. He had a history of recurrent idiopathic pulmonary embolism despite anticoagulation. Diagnostic imaging revealed a large popliteal venous aneurysm. The patient underwent surgical resection of the aneurysm and was prescribed oral anticoagulation postoperatively. Duplex ultrasound at 3 months postoperative revealed unimpeded blood flow in the venous interposition graft. The patient no longer had oedema.
Aneurysms of the popliteal vein should be included in the differential diagnosis of patients with pulmonary embolism. In patients with unexplained recurrent pulmonary embolism despite anticoagulation, additional diagnostic imaging of the lower extremities should be considered and inclusion of duplex ultrasound is recommended.
腘静脉动脉瘤非常罕见，但如果不进行治疗，可能会导致严重且反复的肺栓塞。
一名35岁男性因右膝后方上方肿胀前来门诊血管科进行进一步诊断。尽管接受了抗凝治疗，但他有反复特发性肺栓塞的病史。诊断性影像学检查发现一个巨大的腘静脉动脉瘤。患者接受了动脉瘤手术切除，并在术后接受口服抗凝治疗。术后3个月的双功超声检查显示静脉移植血管内血流通畅。患者不再有水肿。
腘静脉动脉瘤应纳入肺栓塞患者的鉴别诊断。对于尽管接受了抗凝治疗仍有不明原因反复肺栓塞的患者，应考虑对下肢进行额外的诊断性影像学检查，并建议包括双功超声检查。
