Department of Vascular Surgery, Dazhou Central Hospital, Sichuan, China.
Vasc Endovascular Surg. 2021 Jul;55(5):491-494. doi: 10.1177/1538574420976237. Epub 2020 Dec 23.
Popliteal venous aneurysm (PVA) is defined as an increase in the diameter of the popliteal vein, twice its normal dimension. Herein, we report a case of right PVA with severe pulmonary embolism in a 75-year-old woman who presented with sudden chest tightness and dyspnea. Clinical examination revealed hypotension and hypoxemia. Radiographic investigations revealed extensive pulmonary embolism and right fusiform PVA. Following thrombolysis, her blood pressure and oxygen saturation normalized. However, she developed right calf swelling, and angiography revealed a thrombus in the right PVA, which was managed by catheter-directed thrombolysis. Thereafter, a vascular bypass was performed using the left great saphenous vein as a conduit to treat recurrent thrombosis. Subsequent venography indicated a patent vein graft, acceptable blood flow velocity, no thrombosis residue, and no significant thrombosis. Follow-ups at 3, 6, and 12 months revealed satisfactory outcomes. In conclusion, if the systemic condition is conducive, a surgical resection and reconstruction of the popliteal vein is recommended for the treatment of PVAs.
腘静脉动脉瘤（PVA）定义为腘静脉直径增大，超过正常尺寸的两倍。在此，我们报告一例 75 岁女性右侧 PVA 合并严重肺栓塞病例，该患者表现为突发胸闷和呼吸困难。临床检查发现低血压和低氧血症。影像学检查显示广泛的肺栓塞和右侧梭形 PVA。溶栓后，她的血压和血氧饱和度恢复正常。然而，她出现右侧小腿肿胀，血管造影显示右侧 PVA 内有血栓，采用导管定向溶栓治疗。随后，使用左侧大隐静脉作为移植物进行血管旁路手术以治疗复发性血栓形成。随后的静脉造影显示静脉移植物通畅，血流速度可接受，无血栓残留，无明显血栓形成。3、6 和 12 个月的随访结果令人满意。总之，如果全身情况允许，建议对 PVA 进行手术切除和重建腘静脉。
