Tanaka Akiko, Zaidi Taha Syed, Wang S Keisin, Keyhani Arash, Keyhani Kourosh
Department of Cardiothoracic and Vascular Surgery, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, TX.
J Vasc Surg Cases Innov Tech. 2022 Jun 30;8(3):372-374. doi: 10.1016/j.jvscit.2022.06.001. eCollection 2022 Sep.
A 63-year-old man with multiple previous orthopedic procedures in both lower extremities had presented to us for a third opinion regarding the point-specific pain in his right lateral calf. The initial diagnosis had been venous reflux at two other institutions. However, repeat imaging studies demonstrated an aneurysmal gastrocnemius vein without any other abnormalities, such as venous reflux or thrombosis. The patient had received compression stocking therapy for 6 months but had continued to experience increasing pain at night, especially when lying in bed. The patient was reexamined in the supine position, which showed a prominent bulge in the lateral calf. The bulge disappeared while he was in the upright position. The findings from a bedside ultrasound study confirmed that the gastrocnemius vein bulged out when the muscles were relaxed in the supine position and that the muscles compressed the vein in the standing position, squeezing the aneurysm. Thus, the decision was made to proceed with surgical excision. At 7 months after surgery, the patient remained symptom free.
一名63岁男性，双下肢曾多次接受骨科手术，因右小腿外侧特定部位疼痛前来我院寻求第三种意见。另外两家机构最初的诊断为静脉反流。然而，重复影像学检查显示腓肠肌静脉呈瘤样扩张，无其他异常，如静脉反流或血栓形成。该患者接受了6个月的弹力袜治疗，但夜间疼痛仍持续加重，尤其是躺在床上时。患者仰卧位复查时，右小腿外侧可见明显隆起。站立位时隆起消失。床边超声检查结果证实，仰卧位肌肉放松时腓肠肌静脉膨出，站立位时肌肉压迫静脉，挤压动脉瘤。因此，决定进行手术切除。术后7个月，患者症状消失。
